COMPARISON OF BEDSIDE INOCULATION OF CULTURE MEDIA WITH CONVENTIONAL CEREBROSPINAL FLUID CULTURE METHOD IN PATIENTS WITH BACTERIAL MENINGITIS

Abstract

Background: The yield of bacterial cultures from cerebrospinal fluid (CSF) at KenyattaNational Hospital (KNH) is very low. Bedside inoculation of culture media with CSFmay improve yields.

Objective: To compare the culture yield of CSF inoculated onto culture mediumat the bedside to that of CSF inoculated onto culture medium in the microbiologylaboratory.

Design: Cross-sectional comparative study.

Setting: Accident and Emergency Department and medical wards at Kenyatta NationalHospital.

Subjects: Cerebrospinal fluid from patients at KNH with a clinical diagnosis of acutemeningitis.

Results: Two hundred and twenty CSF specimens were obtained during a four monthperiod. S. pneumaniae was isolated from 24 CSF samples and H. influenzae from one.Bacterial cultures were positive in 25 (11.4%, 95% CI 7.0-15.6%) samples inoculatedat the bedside and 23 (10.5%, 95% CI 6.5- 14.5%) samples inoculated at the laboratory.Bacteria were isolated 5 hours earlier in samples inoculated at the bedside (95% CI 4.34-6.86 hrs, p<0.05). Four per cent of S. pneumaniae isolates were resistant to crystallinepenicillin.

Conclusion: There was no significant difference in culture yield after bedside inoculationof culture media with CSF compared to traditional CSF culture method. Bedsideinoculation of culture media with CSF resulted in faster time to positive culture.