1887

Abstract

Summary

A chemical marker of bacterial meningitis was sought by comparing derivatives of sterile cerebrospinal fluid (CSF) with cultures of organisms in spinal fluid and artificial media. The technique of gas chromatography-mass spectrometry with selected ion monitoring (GC-MS-SIM) was used, optimised for the analysis of fatty acids. Twenty candidate ions were screened, and an ion of mass: charge ratio (m/e) 268 was chosen for detection in clinical specimens. The origin of this marker is unknown, but it is probably the molecular ion of a C16:1 fatty acid. In 135 clinical specimens of CSF examined, the m/e 268 ion was found to be a useful marker for the common organisms that cause bacterial meningitis, giving a sensitivity of 88% and a specificity of 98%. The method was more rapid and more sensitive than conventional microscopy and culture, but CSF containing coagulase-negative staphylococci, and some other uncommon pathogens gave inconsistent results. Many organisms produced characteristic ion profiles with multiple-ion monitoring, and this method of chemical analysis holds promise for the rapid diagnosis of bacterial infections to genus or species level.

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1990-01-01
2024-03-29
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References

  1. Amundson S, Braude A I, Davis C E. Rapid diagnosis of infection by gas-liquid chromatography: analysis of sugars in normal and infected cerebrospinal fluid. Appl Microbiol 1974; 28:298–302
    [Google Scholar]
  2. Controni G, Rodriguez W J, Hicks J M et al. Cerebrospinal fluid lactic acid levels in meningitis. J Pediatr 1977; 91:379–384
    [Google Scholar]
  3. Ferguson I R, Tearle P V. Gas liquid chromatography in the rapid diagnosis of meningitis. J Clin Pathol 1977; 30:1163–1167
    [Google Scholar]
  4. Brook I, Bricknell K S, Overturf G D, Finegold S M. Measurement of lactic acid in cerebrospinal fluid of patients with infections of the central nervous system.. J Infect Dis 1978; 137:384–390
    [Google Scholar]
  5. Komorowski R A, Farmer S G, Hanson G A, Hause L L. Cerebrospinal fluid lactic acid in diagnosis of meningitis. J Clin Microbiol 1978; 8:89–92
    [Google Scholar]
  6. D’Souza E, Mandal B K, Hooper J, Parker L. Lactic acid concentration in cerebrospinal fluid and differential diagnosis of meningitis. Lancet 1978; 2:579–580
    [Google Scholar]
  7. Lannigan R, MacDonald M A, Marrie T J, Haldane E V. Evaluation of cerebrospinal fluid lactic acid levels as an aid in differential diagnosis of bacterial and viral meningitis in adults. J Clin Microbiol 1980; 11:324–327
    [Google Scholar]
  8. Greenwood B M, Whittle H C. Dominic-Rajkovic O. Counter-current immunoelectrophoresis in the diagnosis of meningococcal infections. Lancet 1971; 2:519–521
    [Google Scholar]
  9. Berman N S, Siegel S E, Nachum R, Lipsey A, Leedom J. Cerebrospinal fluid endotoxin concentrations in gram-negative bacterial meningitis. J Pediatr 1976; 88:553–556
    [Google Scholar]
  10. Schlossberg D, Brooks J B, Shulman J. Possibility of diagnosing meningitis by gas chromatography: cryptococcal meningitis. J Clin Microbiol 1976; 3:239–245
    [Google Scholar]
  11. Craven R B, Brooks J B, Edman D C et al. Rapid diagnosis of lymphocytic meningitis by frequency-pulsed electron capture gas-liquid chromatography: differentiation of tuberculous, cryptococcal, and viral meningitis. J Clin Microbiol 1977; 6:27–32
    [Google Scholar]
  12. Brooks J B, Kellogg D S, Shepherd M E, Alley C C. Rapid differentiation of the major causative agents of bacterial meningitis by use of frequency-pulsed electron capture gas-liquid chromatography: analysis of acids. J Clin Microbiol 1980; 11:45–51
    [Google Scholar]
  13. Brooks J B, Edman D C, Alley C C, Craven R B, Girgis N I. Frequency-pulsed electron capture gas-liquid chromatography and the tryptophan color test for rapid diagnosis of tuberculous and other forms of lymphocytic meningitis. J Clin Microbiol 1980; 12:208–215
    [Google Scholar]
  14. Brice J L, Tornabene T G, LaForce F M. Diagnosis of bacterial meningitis by gas-liquid chromatography. I. Chemotyping studies o. Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus and Escherichia coli. J Infect Dis 1979; 140:443–452
    [Google Scholar]
  15. LaForce F M, Brice J L, Tornabene T G. Diagnosis of bacterial meningitis by gas-liquid chromatography. II. Analysis of spinal fluid. J Infect Dis 1979; 140:453–464
    [Google Scholar]
  16. French G L, Chan C Y, Cheung S W, Oo K T. Diagnosis of pulmonary tuberculosis by detection of tuberculostearic acid in sputum by using gas chromatography-mass spectrometry with selected ion monitoring. J Infect Dis 1987; 156:356–362
    [Google Scholar]
  17. French G L, Teoh R, Chan C Y, Humphries M J, Cheung S W, O’Mahony G. Diagnosis of tuberculous meningitis by detection of tuberculostearic acid in cerebrospinal fluid. Lancet 1987; 2:117–119
    [Google Scholar]
  18. Woo M L, Leung J W C, French G L. Rickettsial infection presenting as culture-negative meningitis. Postgrad Med J 1988; 64:614–616
    [Google Scholar]
  19. Mitruka B M, Kundargi R S, Jonas A M. Gas chromatography for rapid differentiation of bacterial infections in man. Med Res Eng 1972; 11:7–11
    [Google Scholar]
  20. Mitruka B M. Rapid automated identification of microorganisms in clinical specimens by gas chromatography. In Heden C-G, Illeni T. (eds) New approaches to the identification of microorganisms New York: John Wiley and Sons; 1975123–154
    [Google Scholar]
  21. Maitra S K, Schotz M C, Yoshikawa T T, Guze L B. Determination of lipid A and endotoxin in serum by mass spectroscopy. Proc Natl Acad Sci USA 1978; 75:3993–3997
    [Google Scholar]
  22. Fox A, Schwab J H, Cochran T. Muramic acid detection in mammalian tissues by gas-liquid chromatography-mass spectrometry.. Infect Immun 1980; 29:526–531
    [Google Scholar]
  23. Kiehn T E, Bernard E M, Gold J W M, Armstrong G. Candidiasis: detection by gas-liquid chromatography of d-arabinitol, a fungal metabolite, in human serum. Science 1979; 206:577–580
    [Google Scholar]
  24. Roboz J, Suzuki R, Holland J F. Quantification of arabinitol in serum by selected ion monitoring as a diagnostic technique in invasive candidiasis. J Clin Microbiol 1980; 12:594–601
    [Google Scholar]
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