الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Background: Bacterial meningitis (BM) is a medical emergency, which warrants early diagnosis and aggressive therapy. Most often therapy for bacterial meningitis has to be initiated before the etiology is known. Diagnostic performance of BM has recently improved by using new diagnostic methodologies. Acute patient management is usually initiated after considering fairy elementary finding of cerebrospinal fluid (CSF) examination. The rapid identification of bacteria in the CSF is often difficult to distinguish between bacterial and aseptic (i.e. viral) meningitis. In these situations, molecular diagnostic methods, including Polymerase chain reaction (PCR), may be of help in providing aetiological diagnosis. Besides, bacterial infections are the most damaging, thereby; identifying the source of infection is an important part of developing a treatment plan. Also, rapid detection and identification of bacteria in CSF is crucial in disease management in order to decrease the high mortality rate which is associated with infections in the blood stream or central nervous system (CNS) especially in developing countries Aim of Work: Useful tool for diagnosis of meningitis when culture yield is negative due to antibiotic treatment prior to collection of samples for microbiological analyses. Useful tool for diagnosis of bacterial meningitis when there is a very low microbial tool. Comparative study between the new molecular genetic methods and conventional methods. Methods: The study was conducted over a period of one year from May 2008 to April 2009, where CSF samples were collected from 30 patients admitted to Mansoura University Children’s Hospital (MUCH). Those patients developed signs or symptoms suggestive of bacterial meningitis (BM). Of these patients, 21(70%) were male and 9(30%) were female child. Their ages ranged from 1 month to 13 years (mean age; 35 .35months). Results: The most common presenting features of meningitis included vomiting in 27(90%) of cases, headache in 26 (86.7%), fever in 24 (80%) of cases, neck rigidity in 22 (73.3%) of cases. The commonest frequency of meningitis pathogens among clinically suspected meningitis patients was in infants and young children age group which was 19 (63.3%) out of the thirty meningitis cases. Out of 17 BM isolates, E.coli was the most common isolated pathogen accounting for 7 isolates (23.3%). The second most common isolated BM pathogen was S. pneumoniae; 3 (10%) isolates. The commonest isolation rate of BM pathogens was in the age group of infants and young children (>2months -6 years), in which 10(58.8%) out of 17 isolates were detected in infants and young children. E. coli had the highest rate of isolation in neonatal age group and represented 4(66.6%) followed by S. agalactia which accounted for 2 (33.3%). S. pneumoniae and E.coli had an equal and highest rate of isolation in infant and young children age group, both of them represented 3 (30%) out of 10 cases. Conclusion: We indicate that, universal or BBR-PCR could detect pathogens in 100% of clinically suspected BM cases which makes it an alternative method which is both rapid and sensitive when compared with other conventional methods of diagnosis.