TY - JOUR
T1 - Cerebrospinal fluid inflammatory markers to differentiate between neonatal bacterial meningitis and sepsis
T2 - A prospective study of diagnostic accuracy
AU - NOGBS study group:
AU - Groeneveld, Nina S.
AU - Olie, Sabine E.
AU - Visser, Douwe H.
AU - Snoek, Linde
AU - van de Beek, Diederik
AU - Brouwer, Matthijs C.
AU - Bijlsma, Merijn W.
AU - Baars, Rolanda
AU - van Beek, Ron
AU - Bekker, Vincent
AU - van den Berg, Maartje
AU - Blok, Geert Jan
AU - Breukels, Mijke
AU - Brouwer, Alwin F. J.
AU - Delemarre, Luçan C.
AU - Dings, Anouk
AU - Doedens, Rienus A.
AU - van Dorth, Stefan M.
AU - Driessen, Gertjan
AU - Havers, Hester M.
AU - Heidema, Jojanneke
AU - Hemels, Marieke A. C.
AU - van den Heuvel, Maartje E. N.
AU - van Houten, Marlies
AU - van der Hulst, Flip
AU - Jacobs, Monique A. M.
AU - Janse, Arieke
AU - de Jong, Miranda
AU - van Kaam, Anton H.
AU - Kaspers, Ageeth
AU - van Kassel, Merel N.
AU - van Kempen, Anne A. M. W.
AU - Korbeek, Karen
AU - Klúčovská, Kristine
AU - Kornelisse, René F.
AU - Kuijpers, Taco W.
AU - van Leeuwen, Elisabeth
AU - von Lindern, Jeannette
AU - van Mechelen, Karen
AU - Meijssen, Clemens B.
AU - Noordzij, Jeroen
AU - Oudshoorn, Annemarie
AU - Plötz, Frans B.
AU - Rijpert, Maarten
AU - van Rossem, Maaike
AU - van Scherpenzeel, Machteld
AU - Cornelisse-van Vugt, Renske
AU - Shabo, George
AU - van Wermeskerken, Anne-Marie
AU - Wilms, Janneke
AU - NOGBS study group
N1 - Publisher Copyright: © 2024 The Authors
PY - 2024/5/1
Y1 - 2024/5/1
N2 - 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.
AB - 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.
KW - Cerebrospinal fluid
KW - Diagnostic
KW - Neonatal meningitis
KW - Neonatal sepsis
UR - http://www.scopus.com/inward/record.url?scp=85188721736&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2024.02.013
DO - 10.1016/j.ijid.2024.02.013
M3 - Article
C2 - 38395221
SN - 1201-9712
VL - 142
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
M1 - 106970
ER -