ABSTRACT
Objective: To determine the diagnostic accuracy of pneumococcal antigen detection indiagnosis of pneumococcal meningitis in children. Methods: Purulent meningitis wasdiagnosed according to European Society for Clinical Microbiology and Infectious Diseases(ESCMID) guideline between July 2014 and June 2016. Along with a cerebrospinal fluid(CSF) culture, pneumococcal antigen detection in cerebrospinal fluid (CSF) was performed,and further identification of pathogens was done with 16S rDNA-PCR and high-throughputsequencing. Results: CSF samples collected from 184 children (median age of 1.92 mo).CSF culture was used as the gold standard. 46 (25%) had positive results for culture and 10(5.4%) were pneumococci; 34 (18.5%) were pneumococcal antigen positive. The sensitivityand specificity of pneumococcal antigen detection were 100% (95% CI: 89.4%–100%) and86.2% (95% CI: 96.4%–99.9%), respectively. 92.3% (12/13) were confirmed by nucleic aciddetection to be pneumococci. Conclusions: Pneumococcal antigen detection in CSF hasadequate sensitivity and specificity in diagnosing pneumococcal meningitis.