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BEPA. Boletim Epidemiológico Paulista (Online)

On-line version ISSN 1806-4272

Abstract

FUKASAWA, Lucila Okuyama  and  GRUPO DE TRABALHO DAS MENINGITES BACTERIANAS et al. Validation of the counterimmunoelectrophoresis assay for laboratory diagnosis of meningitis caused by Neisseria meningitidis serogroups A, B, C and W135. BEPA, Bol. epidemiol. paul. (Online) [online]. 2012, vol.9, n.102, pp. 13-20. ISSN 1806-4272.

Counterimmunoelectrophoresis (CIE) is widely used in Brazil for non-culture diagnosis of meningitis caused by Neisseria meningitidis (Men) of serogroups A, B, C, W135 or Haemophilus influenzae serotype b (Hib). The objective of this study was to validate CIE using 301 samples of cerebrospinal fluid (CSF) and serum samples from 236 patients with suspected bacterial meningitis in the cities of São Paulo and Campinas during the period comprised between June 4th, 2007 to May 30th, 2009.In CSF specimens, CIE had a sensitivity of 62.7% (42/67) (95% CI, 50%-74.2%) and specificity of 88.9% (208/234) (95% CI, 84.1% -92.6%) for the detection of Men. In serum, the sensitivity was 35.3% (6/17) (95% CI 14.2% -61.7%) and specificity 90.9% (199/219) (95% CI, 86.3% -94.4%). These parameters were not calculated for the Hib component, due to the unavailability of a significant number of samples with positive culture for this bacterium.Our results showed that the CIE assay although having relatively high specificity, showed low sensitivity, especially in serum samples, indicating that CIE is not recommended as the only diagnostic test for bacterial meningitis. Additionally, it reflects the need of the use of other non-culture tests with high sensitivity and specificity, such as real-time PCR to improve both clinical and the public health surveillance system.

Keywords : Counterimmunoelectrophoresis; Validation; Laboratory Diagnosis; Bacterial Meningitidis; Neisseria meningitidis.

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