Cerebrospinal fluid inflammatory markers to differentiate between neonatal bacterial meningitis and sepsis: A prospective study of diagnostic accuracy
Year: 2024
Type: 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.
Authors: Nina S. Groeneveld, Sabine E. Olie, Douwe H. Visser, Linde Snoek, Diederik van de Beek, Matthijs C. Brouwer, Merijn W. Bijlsma, Rolanda Baars, Ron van Beek, Vincent Bekker, Maartje van den Berg, Geert Jan Blok, Mijke Breukels, Alwin F.J. Brouwer, Luçan C. Delemarre, Anouk Dings, Rienus A. Doedens, Stefan M. van Dorth, Gertjan Driessen, Hester M. Havers, Jojanneke Heidema, Marieke A.C. Hemels, Maartje E.N. van den Heuvel, Marlies van Houten, Flip van der Hulst, Monique A.M. Jacobs, Arieke Janse, Miranda de Jong, Anton H. van Kaam, Ageeth Kaspers, Merel N. van Kassel, Anne A.M.W. van Kempen, Karen Korbeek, Kristine Klúčovská, René F. Kornelisse, Taco W. Kuijpers, Elisabeth van Leeuwen, Jeannette von Lindern, Karen Van Mechelen, Clemens B. Meijssen, Jeroen Noordzij, Annemarie Oudshoorn, Frans B. Plötz, Maarten Rijpert, Maaike van Rossem, Machteld van Scherpenzeel, Renske Cornelisse-van Vugt, George Shabo, Nina M. van Sorge, Jacqueline van der Sluijs, Carmen Lorente Flores, Jacqueline U.M. Termote, Gerdien A. Tramper-Stranders, Gavin W. ten Tusscher, Mirjam van Veen, Marlies Vermaas, Marjoke Verweij, Wouter J. de Waal, Anne-Marie van Wermeskerken, Janneke Wilms, Tom F.W. Wolfs
Institutions: Amsterdam Neuroscience, Amsterdam University Medical Centers, University of Amsterdam, Emma Kinderziekenhuis, Amphia Ziekenhuis, Leiden University, Leiden University Medical Center, Medisch Centrum Haaglanden, Stichting Haaglanden Medisch Centrum, Noordwest Ziekenhuisgroep, Elkerliek Ziekenhuis, Ziekenhuis Nij Smellinghe, Ziekenhuis Amstelland, Gelre Hospitals, Martini Ziekenhuis, Tjongerschans, Haga Hospital, Alrijne Ziekenhuis, Isala, OLVG, Spaarne Gasthuis, Zaans Medisch Centrum, Slingeland Ziekenhuis, Ziekenhuis Gelderse Vallei, Albert Schweitzer Ziekenhuis, Medisch Spectrum Twente, Treant Zorggroep, Erasmus MC, Groene Hart Ziekenhuis, Maastricht University Medical Centre, Meander Medisch Centrum, Reinier de Graaf Hospital, Tergooi, Rijnstate Hospital, Medisch Centrum Leeuwarden, Canisius-Wilhelmina Ziekenhuis, Ziekenhuis Groep Twente, Máxima Medisch Centrum, University Medical Center Utrecht, Sint Franciscus Gasthuis, Dijklander Ziekenhuis, Admiraal De Ruyter Ziekenhuis, VieCuri Medisch Centrum, Diakonessenhuis hospital, Flevoziekenhuis
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
OpenAlex ID: W4392005701