Epidemiology and Infection

Research Article

Incidence of bacterial meningitis in Asia using enhanced CSF testing: polymerase chain reaction, latex agglutination and culture

W. A. KENNEDYa1 c1, S-J. CHANGa1, K. PURDYa1, T. LEa1, P. E. KILGOREa3, J. S. KIMa2, D. D. ANHa4, P. L. T. HUONGa4, B. Q. DONGa5, D. M. TANa5, J. D. CLEMENSa3 and J. I. WARDa1

a1 Department of Paediatrics, UCLA School of Medicine and the Los Angeles Biomedical Research Institute at Harbor–UCLA Medical Center, Torrance, USA

a2 Department of Paediatrics, Jeonbuk National University Hospital, Jeonju, Korea

a3 Science Division, International Vaccine Institute, Seoul, Korea

a4 Department of Bacteriology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam

a5 Guangxi Autonomous Region Center for Disease Prevention and Control, Nanning, China


To enhance the detection of bacterial meningitis in an East Asian surveillance study, we employed cerebrospinal fluid (CSF) bacterial culture, latex agglutination (LA) and polymerase chain reaction–enzyme immunoassay (PCR–EIA) testing for Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). The sensitivity and specificity of CSF PCR–EIA testing was compared to LA and culture. A meningitis case was defined by one positive result for any of the three tests. The sensitivity of H. influenzae CSF PCR–EIA, LA, and culture was 100%, 40% and 57·5% respectively; and for Sp CSF PCR–EIA, LA and culture, the sensitivity was 100%, 58·3% and 66·7%, respectively. Hib and Sp specificity was 100% by each method. CSF PCR–EIA was more sensitive than culture or LA for the detection of Hib and Sp meningitis cases increasing their incidence by 74% and 50% compared to culture respectively. CSF PCR–EIA should be included for the detection of bacterial meningitis in surveillance studies.

(Accepted October 30 2006)

(Online publication February 05 2007)


c1 Author for correspondence: W. A. Kennedy, M.D., Loma Linda University, Department of Pediatrics, 11175 Campus St, Coleman Pavillion, Rm A-1120, Loma Linda, CA 92350, USA. (Email: wkennedy@ahs.llumc.edu)