Assessment of efficacy of urine reagent strips for cerebrospinal fluid analysis as emergency workup in critical care setup

Abstract

Background: Meningitis is a medical emergency that requires to be diagnosed at earliest for early therapeutic interventions for favorable outcome. Cerebrospinal fluid (CSF) biochemistry plays an important role in diagnosis of meningitis. Point-of-care availability of CSF examination for its biochemical parameter is a necessity for resource-limited hospitals. Objectives: The present study evaluates urine reagent strip for leukocyte count, glucose, and proteins for its diagnostic utility in samples of CSF in suspected cases of meningitis. Materials and Methods: 50 CSF samples were evaluated by urine reagent strip method. The results of it were compared with results of definitive test. The values for sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio, positive predictive value (PPV), and negative predictive value were evaluated for reagent strip method. Results: Sensitivity and specificity of reagent strip method for thin-layer chromatography were 83.35% and 100%, respectively, and for glucose, it was 100% and 78.95%, respectively. Sensitivity and specificity of reagent strip method for protein were 78.57% and 100%, respectively. The overall PPV for reagent strip method was 97.06% and PLR was 7.12%. The overall sensitivity and specificity were 86.27% and 87.88%, respectively. Conclusion: The urine reagent strip method works satisfactory at CSF sample evaluation in predicting the diagnosis of meningitis. A resource-limited hospital might find it useful as a point-of-care laboratory workup of CSF.