Discontinuation of CSF Bacterial Antigen Testing

Effective immediately, the CSF Bacterial Antigen Test (BAT) will not be available, nor will it be available as a “send out” reference test (also other Premier Hospital laboratories have already discontinued this test). We will continue to perform gram stain of centrifuged CSF specimens.

BAT has been used to assist in the diagnosis of bacterial meningitis, and showed great sensitivity for the leading causes of bacterial meningitis and specific for Haemophilus Influenzae type B, but lower for other organisms, including Neisseria meningitidis. There are many serotypes of Streptococcus pneumoniae and N. meningitidis that are not detected by the BAT test, and false negatives are possible. BAT also does not detect other causes of bacterial meningitis, such as Listeria monocytogenes; Enterobacteriaceae; or Coagulase negative Staphylococcus, all of which have shown increased incidence as a cause of bacterial meningitis.

A centrifuged gram stains is also generally positive when the antigen test is positive, and is less expensive.

The BAT test is no longer the recommended tests for the diagnosis of bacterial meningitis, as studies have shown that it has limited sensitivity and specificity, as well as other performance problems. Patients with suspected meningitis should continue to be managed, based on other available findings and more reliable laboratory tests, such as CSF Gram stain and culture results.

Please contact the pathology department with any questions or concerns. Call Carolyn Misick, MD, at Good Samaritan (937) 734- 2300.

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