Diagnostic Value of the Leukocyte Esterase Test for Early Detection of Pleocytosis in Cerebrospinal Fluid of Patients with Suspected Acute Bacterial Meningitis

摘要

Background: Rapid and accurate diagnosis of patients with suspectedbacterial meningitis (BM) is crucial to prevent potential subsequent mortality andmorbidity. The aim of this study was to explore the diagnostic value of the rapid leukocyteesterase (LE) strip test in identifying pleocytosis in cerebrospinal fluid (CSF)samples of patients with suspected BM.Methods: A total of 126 patients with suspected meningitis were enrolled in this prospectivestudy. Microscopic examination (cell count and differential) and leukocyteesterase (LE) rapid strip test were performed on cerebrospinal fluid (CSF) samples.Sensitivity, specificity, positive predictive value and negative predictive value of theLE test were determined.Results: Fifty-two patients (41%) had pleocytosis in the CSF, while 48 (38%) patientshad a positive rapid LE strip test result. The diagnostic accuracy of this test forpleocytosis was translated to a sensitivity of 84.6% (95%CI 71.9, 93.1) and a specificityof 94.5% (95%CI 86.7, 98.5), with an area under the receiver operating curveof 0.88.Conclusion: The LE strip test, through rapid and accurate determination of CSF pleocytosis,could be considered as an additional test in the diagnosis of bacterial meningitis.It can be tested at bedside and is feasible to do in resource-limited settings.