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Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children

机译：小儿脑脊液中肠病毒检测与细菌性脑膜炎评分的比较

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Objective To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. Methods A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in S?￡o Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. Results The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. Conclusion Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone.
机译：目的比较脑膜炎患儿细菌性脑膜炎评分与肠道病毒检测在脑脊液中的作用。方法回顾性队列研究基于对2011年至2014年在巴西圣保罗的一家私立和三级医院诊断为脑膜炎的儿科患者的医疗记录进行分析。排除的患者包括重症，紫癜，心室分流或最近的神经外科手术，免疫抑制，伴随细菌感染需要肠胃外抗生素治疗，以及腰椎穿刺前72小时接受抗生素治疗的人。结果研究包括503例患者。排除了64例患者，其中94例未接受所有检查分析。在其余的345例患者中，细菌性脑膜炎组7例，无菌性脑膜炎组338例。两组之间无统计学差异。在细菌性脑膜炎评分分析中，在338例可能的无菌性脑膜炎（阴性培养）患者中，其中121例细菌性脑膜炎评分为1分或更高，敏感性为100％，特异性为64.2％，阴性预测值为。 100％。在121例细菌性脑膜炎评分阳性的患者中，有71％（86例）的脑脊液中肠病毒检测阳性。结论在脑脊液中检测肠病毒可有效区分细菌与病毒性脑膜炎。与细菌性脑膜炎评分一起分析测试时，特异性比单独的细菌性脑膜炎评分更高。

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