Adjustment of cerebrospinal fluid cell counts for a traumatic lumbar puncture does not aid diagnosis of meningitis in neonates.

摘要

Question Among neonates with suspected meningitis, does the cerebrospinal fluid (CSF) white blood cell count need to be adjusted for a traumatic lumbar puncture?Design Cohort study performed between 1997 and 2004.Setting One hundred fifty neonatal intensive care units in the United States.Participants A total of 6374 neonates <=30 days who underwent a lumbar puncture.Intervention CSF white blood cell counts were adjusted downward for traumatic lumbar punctures (denned as CSF specimens with >=500 red blood cells/mm~3) with several commonly used methods.Outcomes Sensitivity, specificity, likelihood ratios, and area under the receiver operating characteristic curve of unadjusted and adjusted CSF white blood cell counts for predicting culture or Gram stain-positive meningitis in neonates with traumatic lumbar punctures.