AI Article Synopsis
- This study assessed the effectiveness of cerebrospinal fluid (CSF) inflammatory markers in diagnosing bacterial meningitis in newborns with sepsis or meningitis.
- It involved analyzing CSF samples from neonates with confirmed infections from Group B Streptococcus or E. coli, measuring various markers to determine their concentrations using advanced technology.
- Results showed that specific biomarkers, especially CSF leukocyte count, were highly accurate in distinguishing between definitive meningitis and sepsis, suggesting these markers can aid in clinical decision-making.
Article Abstract
Objectives: We evaluated the diagnostic accuracy of cerebrospinal fluid (CSF) inflammatory markers for diagnosing bacterial meningitis in neonates with sepsis and/or meningitis.
Methods: Cases were identified from a prospective multicenter study including patients aged 0-3 months with Group B Streptococcal (GBS) or Escherichia coli culture positive sepsis/meningitis. CSF CXCL10, MDC, IL-6, IL-8, IL-10, TNF- α, MIF, IL-1RA, CXCL13, IL-1β, CRP and procalcitonin concentrations were measured with Luminex technology.
Results: In 61/373 patients (17%) residual CSF from the lumbar puncture was available, of whom 16 (26%) had definitive meningitis, 15 (25%) probable meningitis and 30 (49%) had sepsis. All biomarkers were detectable in CSF and showed significantly higher concentrations in definitive meningitis versus sepsis patients and six biomarkers in probable meningitis versus sepsis patients. Discrimination between definitive meningitis and sepsis was excellent for IL-1RA (area under the receiver operating characteristic curve [AUC] 0.93), TNF-α (AUC 0.92), CXCL10 (AUC 0.90), IL-1β (AUC 0.92), IL-6 (AUC 0.94), IL-10 (AUC 0.93) and a combination of IL-1RA, TNF-α, CXCL-10 and CSF leukocyte count (AUC 0.95). CSF leukocyte count remained the predictor with the highest diagnostic accuracy (AUC 0.96).
Conclusion: CSF inflammatory markers can be used to differentiate between neonatal sepsis and meningitis.
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| http://dx.doi.org/10.1016/j.ijid.2024.02.013 | DOI Listing |
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