Bacterial counts in cerebrospinal fluid of children with meningitis

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Abstract
Eighty-five cerebrospinal fluid (CSF) specimens from the same number of pediatric patients with meningitis were examined to determine the bacterial count and the relationship of this count to the microscopy results, the ages of the patients and the bacterial species isolated. Bacterial counts ranged from 2 × 10 to 4 × 109 CFU/ml CSF. Twenty-five percent of the 85 CSF specimens positive forHaemophilus influenzae type b,Neisseria meningitidis, Streptococcus pneumoniae, Escherichia coli K1 and group B streptococci had counts of 107 CFU/ml or higher. Children between 1 and 6 months of age had significantly higher counts (p < 0.05) than the other age groups. The three patients who had positive CSF cultures 24 h after the start of therapy all had initial bacterial counts of 107 CFU/ml or higher. The detection limit for Gram stain/microscopy was 105 CFU/ml. No correlation was found between bacterial count and the number of polymorphonuclear leukocytes.