Cerebrospinal Fluid Enrichment Broth Cultures Rarely Contribute to the Diagnosis of Bacterial Meningitis
Division of Infectious Diseases and the Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.The Pediatric Infectious Disease Journal (Impact Factor: 2.72). 03/2012; 31(3):318-20. DOI: 10.1097/INF.0b013e318243e502
This study included children undergoing lumbar puncture in the emergency department. Bacteria were isolated from 34 (1.7%) of 1898 cerebrospinal fluid (CSF) enrichment broth cultures; 30 were contaminants. The primary CSF Gram stain was negative in all specimens with a positive enrichment broth culture. Enrichment broth cultures rarely contributed to the diagnosis of bacterial meningitis, and positive CSF enrichment broth cultures contributed to diagnostic uncertainty.
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ABSTRACT: The aim of this study was to assess the diagnostic value of the BACTEC FX blood culture (BC) system as compared to the agar culture (AC) of cerebrospinal fluid samples (CSF), evaluating the recovery rate and the time to detection of microorganisms in a 3.5-year period. From December 2011 to May 2015, 1,326 CSF samples (694 patients) were submitted to both AC and BC. Among the 150 positive samples (96 patients), 165 microorganisms were detected: 81 by both the protocols, 77 by BC alone and 7 by AC alone, demonstrating a higher detection rate of BC (95.8%) than AC (53.3%). Although BC presents some disadvantages, it is able to improve the yield of clinically significant microorganisms and it could potentially reduce the reporting time as compared to AC. The results obtained highlighted the necessity of a combined approach for the successful detection of central nervous system microbial infections.
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