Automated screening of bacterial meningitis by cytofluorimetric analysis of cerebrospinal fluid: preliminary results.

This study was planned to assess the diagnostic performance of the automated urine particle analyzer Sysmex UF-1000i for the rapid screening of cerebrospinal fluid (CSF) in patients with suspected meningitis. Cytometric analyses with either optical microscopy (OM) or UF-1000i, along with assessment of glucose and protein in CSF, were performed on 101 consecutive CSF of patients with suspected meningitis. In 50 out of 101 samples, cultural analysis was also performed with different culture media. Four different diagnostic combination were developed, with different mix of the tested parameters. A high correlation was found between OM and UF-1000i (r=0.99; mean bias, -4.9/μL). The diagnostic agreement was 0.90 in adults and 0.97 in children. The diagnostic agreement between CSF culture and bacterial count by UF-1000i was 0.98, with 1.00 sensitivity and 0.98 specificity. Results showed that the diagnostic combination based on CSF glucose and total proteins, cytometric analysis (leukocyte count ± neutrophilia) and bacterial count on UF1000i exhibited the best performance when compared with microbiological examination (area under ROC curve, 1.00). In conclusion, the results of this study show that the combination of two rapid clinical chemistry tests such as glucose and total proteins with UF-1000i analysis could represent a valid approach for supporting more complex analyses or even for replacing OM and CSF culture during stat examination and to achieve a quick detection of central nervous system infections.