PDF(Pubmed)
Abstract：
UNASSIGNED: Colorimetric reagent dipstick (CRD) for leukocyte esterase (LE) has shown potential for diagnosing and ruling out bacterial meningitis. Potential advantages over traditional cerebrospinal fluid (CSF) analysis include the small quantity of CSF required, rapid results, and easy interpretation. Our study aimed to determine whether clinicians in LMICs could accurately diagnose bacterial meningitis using CRD at the bedside.
UNASSIGNED: A convenience sample of 143 patients requiring lumbar puncture for possible meningitis were enrolled from 1 October 2018 to 31 December 2019 at three hospitals, one each in rural Burundi, the Democratic Republic of Congo, and Kenya. CSF was analyzed using CRD followed by traditional laboratory-based analysis by technicians blinded to bedside results. Results were analyzed for concordance rates, sensitivity/specificity, positive and negative predictive values and impact on clinical decision-making.
UNASSIGNED: One hundred and one patients were included in the analysis. The prevalence of bacterial meningitis in the convenience sample was 35% (35/101) as defined by microscopy or positive Gram stain. Using a threshold of \"any positivity\" for LE on the CRD, bedside testing correctly identified 33/35 cases (sensitivity 94.3%) and had a NPV of 92%. When only a clearly positive (≥ \"+\" for LE) CRD criterion was used, sensitivity and NPV were 77.1% and 86.2%, respectively.
UNASSIGNED: Despite considerable promise, in our study, color reagent dipstick analysis of CSF did not perform well enough to rule out meningitis or screen samples for the need for microscopy. The development of a CSF-specific dipstick should be considered.
UNASSIGNED: A convenience sample of 143 patients requiring lumbar puncture for possible meningitis were enrolled from 1 October 2018 to 31 December 2019 at three hospitals, one each in rural Burundi, the Democratic Republic of Congo, and Kenya. CSF was analyzed using CRD followed by traditional laboratory-based analysis by technicians blinded to bedside results. Results were analyzed for concordance rates, sensitivity/specificity, positive and negative predictive values and impact on clinical decision-making.
UNASSIGNED: One hundred and one patients were included in the analysis. The prevalence of bacterial meningitis in the convenience sample was 35% (35/101) as defined by microscopy or positive Gram stain. Using a threshold of \"any positivity\" for LE on the CRD, bedside testing correctly identified 33/35 cases (sensitivity 94.3%) and had a NPV of 92%. When only a clearly positive (≥ \"+\" for LE) CRD criterion was used, sensitivity and NPV were 77.1% and 86.2%, respectively.
UNASSIGNED: Despite considerable promise, in our study, color reagent dipstick analysis of CSF did not perform well enough to rule out meningitis or screen samples for the need for microscopy. The development of a CSF-specific dipstick should be considered.
摘要：
未经证实：白细胞酯酶（LE）的比色试剂试纸（CRD）已显示出诊断和排除细菌性脑膜炎的潜力。与传统的脑脊液（CSF）分析相比，潜在的优势包括所需的少量CSF，快速的结果，和简单的解释。我们的研究旨在确定LMICs的临床医生是否可以在床边使用CRD准确诊断细菌性脑膜炎。
UNASSIGNED：从2018年10月1日至2019年12月31日，在三家医院招募了143名需要腰椎穿刺治疗可能的脑膜炎患者的便利样本。布隆迪农村各有一个，刚果民主共和国,肯尼亚。使用CRD分析CSF,然后由不了解床边结果的技术人员进行传统的基于实验室的分析。分析结果的一致性率，敏感性/特异性，阳性和阴性预测值以及对临床决策的影响。
UNASSIGNED：分析中包括了100名患者。根据显微镜检查或革兰氏染色阳性定义，方便样本中细菌性脑膜炎的患病率为35％（35/101）。使用CRD上LE的“任何阳性”阈值，床旁检测正确识别33/35例(敏感性94.3%),NPV为92%.当仅使用明显阳性(对于LE≥“+”)CRD标准时，敏感性和净现值分别为77.1%和86.2%，分别。
未经批准：尽管有相当大的承诺，在我们的研究中,CSF的彩色试剂试纸分析结果不足以排除脑膜炎或筛选需要显微镜检查的样本.应考虑开发CSF特异性试纸。
UNASSIGNED：从2018年10月1日至2019年12月31日，在三家医院招募了143名需要腰椎穿刺治疗可能的脑膜炎患者的便利样本。布隆迪农村各有一个，刚果民主共和国,肯尼亚。使用CRD分析CSF,然后由不了解床边结果的技术人员进行传统的基于实验室的分析。分析结果的一致性率，敏感性/特异性，阳性和阴性预测值以及对临床决策的影响。
UNASSIGNED：分析中包括了100名患者。根据显微镜检查或革兰氏染色阳性定义，方便样本中细菌性脑膜炎的患病率为35％（35/101）。使用CRD上LE的“任何阳性”阈值，床旁检测正确识别33/35例(敏感性94.3%),NPV为92%.当仅使用明显阳性(对于LE≥“+”)CRD标准时，敏感性和净现值分别为77.1%和86.2%，分别。
未经批准：尽管有相当大的承诺，在我们的研究中,CSF的彩色试剂试纸分析结果不足以排除脑膜炎或筛选需要显微镜检查的样本.应考虑开发CSF特异性试纸。
