CEREBROSPINAL FLUID TO SERUM GLUCOSE RATIO COMPARED WITH THE CEREBROSPINAL FLUID CULTURE RESULT IN THE PATIENT WITH

BACTERIAL MENINGITIS
Rivadin Nurwan, Elisabeth S. Herini, Agung Triono Department of Child Health, Medical School, Universitas Gadjah Mada - DR Sardjito Hospital Yogyakarta - Indonesia

Lumbar puncture (LP) is an important and frequently performed procedure in the meningitis patient. The nature of an underlying pathology is often reflected by changes in cerebrospinal fluid (CSF) constituents. The widely accepted normal ratio between blood and CSF glucose level is between 0.6 and 0.8 Less than this level indicates the presence of diffuse meningeal disorders, such as bacterial, fungal, or tuberculous infection There are limited resources to perform CSF culture in the district hospital

To explore the relevance of CSF to serum glucose ratio as indicator of bacterial meningitis in children

Cross sectional study Data from cerebrospinal fluid, serum glucose concentrations and their ratio to each other collected from 1 month- 18 years old children with diagnose meningitis. Setting: Dr.Sardjito General Hospital Yogyakarta in February until June 2011 Bacterial meningitis were defined as having a positive culture of cerebrospinal fluid and aseptic meningitis if theres absence of bacterial growth on culture The data are analyzed by SPSS 16.0 ROC Curve Subject characteristic <1 Age (year) 1-4 >4 Sex Male Female CSF to serum glucose ratio < 0.40 0.40-0.49 Number of samples 12 17 2 15 16 7 1

0.50-0.59
0.60-0.69 0.70

2
5 16 12 19

CSF culture

Positive Negative

In this research, the cut off points for CSF to serum glucose ratio is 0,64 with sensitivity and spesificity 73% and 59% respectively