20 February 2018 Lens-free microscopy of cerebrospinal fluid for the laboratory diagnosis of meningitis
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The cytology of the cerebrospinal fluid is traditionally performed by an operator (physician, biologist) by means of a conventional light microscope. The operator visually counts the leukocytes (white blood cells) present in a sample of cerebrospinal fluid (10 μl). It is a tedious job and the result is operator-dependent. Here in order to circumvent the limitations of manual counting, we approach the question of numeration of erythrocytes and leukocytes for the cytological diagnosis of meningitis by means of lens-free microscopy. In a first step, a prospective counts of leukocytes was performed by five different operators using conventional optical microscopy. The visual counting yielded an overall 16.7% misclassification of 72 cerebrospinal fluid specimens in meningitis/non-meningitis categories using a 10 leukocyte/μL cut-off. In a second step, the lens-free microscopy algorithm was adapted step-by-step for counting cerebrospinal fluid cells and discriminating leukocytes from erythrocytes. The optimization of the automatic lens-free counting was based on the prospective analysis of 215 cerebrospinal fluid specimens. The optimized algorithm yielded a 100% sensitivity and a 86% specificity compared to confirmed diagnostics. In a third step, a blind lens-free microscopic analysis of 116 cerebrospinal fluid specimens, including six cases of microbiology confirmed infectious meningitis, yielded a 100% sensitivity and a 79% specificity. Adapted lens-free microscopy is thus emerging as an operator-independent technique for the rapid numeration of leukocytes and erythrocytes in cerebrospinal fluid. In particular, this technique is well suited to the rapid diagnosis of meningitis at point-of-care laboratories.
© (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Robin Delacroix, Robin Delacroix, Sophie Nhu An Morel, Sophie Nhu An Morel, Lionel Hervé, Lionel Hervé, Thomas Bordy, Thomas Bordy, Pierre Blandin, Pierre Blandin, Jean-Marc Dinten, Jean-Marc Dinten, Michel Drancourt, Michel Drancourt, Cédric Allier, Cédric Allier, } "Lens-free microscopy of cerebrospinal fluid for the laboratory diagnosis of meningitis ", Proc. SPIE 10510, Frontiers in Biological Detection: From Nanosensors to Systems X, 105100K (20 February 2018); doi: 10.1117/12.2289539; https://doi.org/10.1117/12.2289539

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