New test can rapidly and accurately diagnose bacterial meningitis

Researchers at Amsterdam UMC have developed a new diagnostic test that can quickly and accurately diagnose bacterial meningitis. The test measures the CRP protein in cerebrospinal fluid, a protein that is already often tested in blood to detect bacterial infections. Research shows that elevated CRP in cerebrospinal fluid is a very reliable indicator of bacterial meningitis. Currently it often takes a long time before meningitis is diagnosed, which delays the start of adequate treatment. The study is published today in The Lancet Regional Health Europe. 

Bacterial meningitis is a life-threatening condition in which one in six patients die and half of the survivors have residual symptoms. Thus, prompt diagnosis and treatment are crucial. 

The distinction between bacterial meningitis and similar conditions is often difficult for doctors. Until now, reliable diagnostic tests that could quickly distinguish were lacking."

Matthijs Brouwer, last author and Amsterdam UMC neurologist 

Reliable indicator

Researchers at Amsterdam UMC have discovered that the CRP protein in cerebrospinal fluid is a very reliable indicator of bacterial meningitis. CRP is already frequently tested in blood to detect bacterial infections, but the value of this test in cerebrospinal fluid had not been well researched until now. After previous successful laboratory tests, the researchers now showed that the device that measures CRP in blood is also sensitive enough to measure CRP in cerebrospinal fluid. 

"It is a huge gain that the existing infrastructure of the laboratory can be used for the CRP measurements in cerebrospinal fluid. As a result, the test result is already known half an hour after the epidural and the correct treatment of the patient can therefore be started quickly," says Brouwer. 

Daily practice

Since June 2024, the new test has been used in the daily practice of the Amsterdam UMC. In the study published today, researchers describe how the test was introduced and how effective it is in practice.

"Our results show that all patients with bacterial meningitis had an elevated CRP in their cerebrospinal fluid. This was the case in only a few patients without bacterial meningitis, " adds Brouwer. The test also proved reliable in additional studies in children and patients from at Aalborg University Hospital in Denmark. 

Broad application in hospitals 

It is expected that more hospitals will adopt the test, because it can easily be performed in laboratories with existing equipment. The test only costs between three and five euros, providing an affordable and accessible solution to diagnose and treat bacterial meningitis faster. 

"Any laboratory in which CRP is measured in blood can introduce this test for cerebrospinal fluid tomorrow. We could not have predicted in advance that a new diagnostic test would be used in patients within a year of its discovery," concludes Brouwer.