Affiliations: Department of Pediatric Medicine, Medical College and
Hospital, Kolkata, India | Department of Obstetrics and Gynecology, Medical
College and Hospital, Kolkata, India
Note: [] Correspondence: Dr. Mihir Sarkar, Department of Pediatric
Medicine, Medical College and Hospital, Kolkata, India. Tel.: +91 923 152 0975;
E-mail: mihir_iway_2005@sify.com
Abstract: To evaluate predictive value of blood culture as an effective
alternative laboratory tool for isolation of causative organism in acute
pyogenic meningitis. It is a hospital based prospective longitudinal hospital
based study performed from May 2007 to May 2009. A total number of 310 children
of age group 2 months-14 years who presented to the hospital with probability
of bacterial meningitis were screened in the study. Eighty cases excluded by
preset exclusion criteria and rest 230 formed the analytic sample. Pretreatment
blood culture with concomitant lumbar puncture or lumbar puncture within 2 h of
antibiotic administration for cerebrospinal fluid analysis was obtained. The
main outcome parameter was the predictive value of blood culture for isolation
of causative organism in acute bacterial meningitis. Blood culture revealed a
sensitivity of 73.28% (95% confidence interval [CI]: 64.85%–80.63%),
specificity of 87.88% (95% CI: 79.78%–93.58%), positive predictive value
of 88.9% (95% CI: 81.40%–94.13%), negative predictive value of 71.31%
(62.42%–79.14%), positive likelihood ratio of 5.97 and negative
likelihood ratio of 0.30. Probability of isolation of causative organism by
blood culture in bacterial meningitis was found to be highest among infants
(82%) and least in children aged above 5~years (54.17%). When compared to gold
standard cerebrospinal fluid diagnostic criteria, blood culture has a high
sensitivity, specificity, positive predictive value and likelihood ratio to be
an effective alternative laboratory tool for isolation of causative organism in
acute bacterial meningitis especially in infants and younger children.
