[The advantages of agglutination and precipitation tests used in the serological diagnosis of meningitis due to H. influenza type B].

Abstract

During the period January 1985-July 1988, 532 purulent CSF taken from patients with meningitis, aged between 3 weeks and 91 years, were studied by microscopic examination, cultivation and for H. influenzae type B (HITB) also by coagglutination (COA), counterimmunoelectrophoresis (CIE) and double immunodiffusion (DID) in agarose gel. Positive CSFs were taken from the patients aged 1 month-24 years old, of which 76% from children under 5 years old, and 42% from children under one year. 65.9% of the patients were males; the disease was more frequent in the first and last 4 months of the year, with the highest incidence in April. 12 bacterial spectra were found: N. meningitidis--62.97%, Str. pneumoniae--9.77%, H. influenzae type B--8.27%, and also Salmonella, E. coli, Staphylococcus, Klebsiella, Acinetobacter, beta-hemolytic Streptococcus, Alcaligenes, Proteus and Enterobacter in 4.70; the rest of 14.28% had indefinite etiology. H. influenzae was evidenced in CSF by microscopic examination in 3.38%, by cultivation in 3.94%, and the soluble antigen of HITB by COA in 8.27%, by CIE in 8.08% and by DID in 7.33%. The sensibility order of the tests was: COA, CIE, DID, cultivation and microscopic examination. The COA and CIE techniques are recommended for the current use in examination of the purulent CSF due to their simplicity, rapidity, sensibility, specificity and possibility of establishing the diagnosis when the bacteriologic techniques are negative.