The Journal of Pediatrics
Volume 152, Issue 3 , Pages 378-382, March 2008

Sensitivity of the Bacterial Meningitis Score in 889 Children with Bacterial Meningitis

  • François Dubos, MD

      Affiliations

    • From the Clinical Epidemiology Unit, Department of Pediatrics, Saint-Vincent-de-Paul Hospital, AP–HP and Paris Descartes University, Paris, France
    • Pediatric Emergency and Infectious Diseases Unit, Jeanne-de-Flandre Hospital, CHU Lille and Lille-2 University, Lille, France
    • INSERM U149, Paris, France.
    • ,
  • France De la Rocque, MD

      Affiliations

    • Groupe de Pathologie Infectieuse Pédiatrique – Association Clinique et Therapeutique Infantile du Val-de-Marne (GPIP/ACTIV Bacterial Meningitis French Surveillance Network), Saint-Maur-des-Fossés, France
    • ,
  • Corinne Levy, MD

      Affiliations

    • Groupe de Pathologie Infectieuse Pédiatrique – Association Clinique et Therapeutique Infantile du Val-de-Marne (GPIP/ACTIV Bacterial Meningitis French Surveillance Network), Saint-Maur-des-Fossés, France
    • ,
  • Edouard Bingen, MD

      Affiliations

    • Groupe de Pathologie Infectieuse Pédiatrique – Association Clinique et Therapeutique Infantile du Val-de-Marne (GPIP/ACTIV Bacterial Meningitis French Surveillance Network), Saint-Maur-des-Fossés, France
    • ,
  • Yannick Aujard, MD

      Affiliations

    • Groupe de Pathologie Infectieuse Pédiatrique – Association Clinique et Therapeutique Infantile du Val-de-Marne (GPIP/ACTIV Bacterial Meningitis French Surveillance Network), Saint-Maur-des-Fossés, France
    • ,
  • Robert Cohen, MD

      Affiliations

    • Groupe de Pathologie Infectieuse Pédiatrique – Association Clinique et Therapeutique Infantile du Val-de-Marne (GPIP/ACTIV Bacterial Meningitis French Surveillance Network), Saint-Maur-des-Fossés, France
    • ,
  • Gérard Bréart, MD

      Affiliations

    • INSERM U149, Paris, France.
    • ,
  • Bacterial Meningitis Study Group
    • ,
  • Dominique Gendrel, MD

      Affiliations

    • From the Clinical Epidemiology Unit, Department of Pediatrics, Saint-Vincent-de-Paul Hospital, AP–HP and Paris Descartes University, Paris, France
    • ,
  • Martin Chalumeau, MD, PhD

      Affiliations

    • From the Clinical Epidemiology Unit, Department of Pediatrics, Saint-Vincent-de-Paul Hospital, AP–HP and Paris Descartes University, Paris, France
    • INSERM U149, Paris, France.
    • Corresponding Author InformationReprint requests: Dr. Martin Chalumeau, Clinical Epidemiology Unit − Department of Pediatrics, Saint-Vincent-de-Paul Hospital, 82 avenue Denfert-Rochereau, 75014 Paris, France.

Received 21 March 2007; received in revised form 25 May 2007; accepted 6 July 2007. published online 22 October 2007.

Objective

To validate sensitivity of the bacterial meningitis score (BMS) in a large population of children with bacterial meningitis (BM).

Study design

Secondary analysis of prospective data for children presenting with BM to a hospital emergency department between January 2001 and February 2005. The BMS was applied to all children with acute BM using the same inclusion criteria proposed by the authors of the rule. The sensitivity of the rule was calculated.

Results

Of the 900 children aged 29 days to 18 years with acute BM who met all inclusion criteria, 889 had enough data for assigning the BMS. Use of the BMS correctly identified 884 children with BM, for 99.6% sensitivity (95% confidence interval: 98.9% to 99.8%).

Conclusions

The sensitivity of the BMS to detect disease was very high, but a few cases of BM were missed. Further refinements of the BMS may be warranted to lower the false-negative rate.

Abbreviations: BM, Bacterial meningitis, BMS, Bacterial meningitis score, CSF, Cerebrospinal fluid, ED, Emergency department, PCT, Procalcitonin

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 Supported by the Pediatric Infectious Diseases Group of the French Pediatrics Society (GPIP), the Association Clinique et Therapeutique Infantile du Val de Marne (ACTIV), the DRC (CRC 03154) and the URC-Cochin, AP-HP, the Fonds d’Etudes et de Recherche du Corps Médical des Hôpitaux de Paris, and the Fondation Bayer Santé.

PII: S0022-3476(07)00664-6

doi:10.1016/j.jpeds.2007.07.012

The Journal of Pediatrics
Volume 152, Issue 3 , Pages 378-382, March 2008

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