DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20203443

Utility of urine reagent strips in rapid bedside diagnosis of bacterial meningitis

Nanda Patil, Sujata Kanetkar, Garima Agarwal, Supriya Karmakar

Abstract


Background: Bacterial meningitis is a medical emergency and late diagnosis and treatment can lead to neurological damage and death. For definitive diagnosis of meningitis, laboratory based CSF analysis is required which is based on microscopy, protein and sugar estimation. This requires laboratory set up with experienced pathologist and long turn around time. Hence urinary reagent strips as a semiquantitative method can be applied for CSF analysis. This method can be used where laboratory set up is not available as well as bedside test for early diagnosis of bacterial meningitis. The present prospective study was undertaken to evaluate the utility of urine reagent strips in rapid diagnosis of bacterial meningitis. The aim of the present was to evaluate the role of urine reagent strips in the analysis of cerebrospinal fluid in suspected cases of meningitis.

Methods: The prospective study was carried out in the department of pathology in a tertiary care centre for a period of 6 months from September 2018 to February 2019. CSF analysis of suspected cases of meningitis was done with urine reagent strip as well as with standard laboratory method. The results of both were compared.

Results: Out of 79 cases of meningitis, 68.35% cases were of bacterial meningitis. The specificity and sensitivity of CSF analysis with reagent strip was 93.33% and 82.35% respectively, for cell count, 94.4% and 88.2% respectively for proteins and 91.3% and 60.2% respectively for glucose.

Conclusions: Semiquantitative analysis of CSF sample with urine reagent strips helps in rapid diagnosis of bacterial meningitis and can be useful to facilitate therapeutic decisions in resource constrained settings.


Keywords


Bacterial meningitis, CSF analysis, Reagent strips

Full Text:

PDF

References


Kumar A, Debata PK, Ranjan A, Gaind R. The role and reliability of rapid bedside diagnostic test in early diagnosis and treatment of bacterial meningitis. Indian J Pediatr. 2015;82:311-4.

Scarborough M, Thwaites GE. The diagnosis and management of acute bacterial meningitis in resource-poor settings. Lancet Neurol. 2008;7:637-48.

Sujaya Mazumder, BS Ramya, Dayananda S Biligi. Utility of urine reagent strips in cerebrospinal fluid analysis: An aid to bedside diagnosis of meningitis. Indian J Pathol Microbiol. 2018;61(3):356-9.

Valmari P, Peltola H, Ruuskanen O, Korvenranta H. Childhood bacterial meningitis: Initial symptoms and signs related to age, and reasons for consulting a physician. Eur J Pediatr. 1987;146:515-8.

Chikkannaiah P, Benachinmardi KK, Srinivasamurthy V. Semi-quantitative analysis of cerebrospinal fluid chemistry and cellularity using urinary reagent strip: An aid to rapid diagnosis of meningitis. Neurol India. 2016;64:50-5.

Molyneux E. Where there is no laboratory, a urine patch test helps diagnose meningitis. J Neurosci Rural Pract 2013;4:117-8.

Parmar RC, Warke S, Sira P, Kamat JR. Rapid diagnosis of meningitis using reagent strips. Indian J Med Sci. 2004;58:62-6.

Joshi D, Kundana K, Puranik A, Joshi R. Diagnostic accuracy of urinary reagent strip to determine cerebrospinal fluid chemistry and cellularity. J Neurosci Rural Pract. 2013;4:140-5.

Romanelli RM, Thome EE, Duarte FM, Gomes RS, Camargos PA, Freire HB. Diagnosis of meningitis with reagent strips. J Pediatr (Rio J) 2001;77:203-8.

Boney V, Gledhill RF. Use of reagent strips to diagnose bacterial meningitis. Lancet. 1997;349:287-8.