Microbial genome count in cerebrospinal fluid compared with clinical characteristics in pneumococcal and Haemophilus influenzae type b meningitis in children

Cerebrospinal fluid genome counts were determined by quantitative real-time polymerase chain reaction from 121 children: 36 with Streptococcus pneumoniae and 85 with Haemophilus influenzae meningitis. To examine the interactions of genome count and to determine its prognostic importance, we projected the results against findings on admission and different outcomes. The genome count varied vastly in both meningitides ranging from 0 to 9 250 000/μL. The genome quantity was weakly associated with only some of the patient findings on admission. High counts predicted neurologic (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.09–1.69; P = 0.006 for 1 log increase) but not audiologic sequelae. They also predicted death in S .pneumoniae (OR = 2.05; 95% CI, 1.08–3.87; P = 0.03) but not in H. influenzae meningitis.