Role of Cerebrospinal Fluid Il-8 as a Marker for Differentiation between Acute Bacterial and Aseptic Meningitis

Abdelmoez, Amal Tohamy; Zaky, Doaa Zakaria; Maher, Amany M.

doi:10.12816/0006460

Cited by 6 publications

(6 citation statements)

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“…Neutrophil blood counts provided limited diagnostic value to identify bacterial infections (sensitivity 42%-76%; specificity 71.4%-88%) to distinguish bacterial from non-bacterial infections [ 26 , 29 , 37 ]. Lower blood lymphocyte counts were associated (4/7, 57%) with bacterial infections, although the corresponding diagnostic values were not reported in any of the reviewed studies [ 30 , 33 , 37 , 40 ].…”

Section: Resultsmentioning

confidence: 96%

“…Studies that evaluated WBC counts in blood reported a high degree of variability in diagnostic performance. All of the studies comparing WBC counts in CSF in patients with bacterial meningitis versus non-bacterial meningitis infections, generally reported high sensitivities and specificities [ 21 , 23 , 25 , 30 , 31 ] to detect bacterial infections. In CSF, Linder et al .…”

Section: Resultsmentioning

confidence: 99%

“…The majority (5/7; 71%) of studies that evaluated ESR, a marker for inflammation found it to be a specific marker in differentiating between bacterial and non-bacterial infections [ 24 , 29 , 30 , 36 , 37 , 41 , 49 ]. Patients with bacterial infections had a higher ESR than patients with viral infections [ 30 ]; [ 49 ]; [ 29 , 36 , 37 ]. Two studies reported the diagnostic performance characteristics of ESR, which ranged from 77.4%-85% sensitivity and 78.3%-90% specificity to identify bacterial infections [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…All six studies that investigated protein in CSF reported statistically significantly higher levels in bacterial versus viral meningitis [ 21 , 23 , 25 , 28 , 30 , 31 ]. Four out of 5 (80%) studies evaluating glucose levels in blood or CSF to discriminate bacterial from viral meningitis reported statistically significant results [ 21 , 23 , 25 , 28 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Host Biomarkers for Distinguishing Bacterial from Non-Bacterial Causes of Acute Febrile Illness: A Comprehensive Review

et al. 2016

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BackgroundIn resource limited settings acute febrile illnesses are often treated empirically due to a lack of reliable, rapid point-of-care diagnostics. This contributes to the indiscriminate use of antimicrobial drugs and poor treatment outcomes. The aim of this comprehensive review was to summarize the diagnostic performance of host biomarkers capable of differentiating bacterial from non-bacterial infections to guide the use of antibiotics.MethodsOnline databases of published literature were searched from January 2010 through April 2015. English language studies that evaluated the performance of one or more host biomarker in differentiating bacterial from non-bacterial infection in patients were included. Key information extracted included author information, study methods, population, pathogens, clinical information, and biomarker performance data. Study quality was assessed using a combination of validated criteria from the QUADAS and Lijmer checklists. Biomarkers were categorized as hematologic factors, inflammatory molecules, cytokines, cell surface or metabolic markers, other host biomarkers, host transcripts, clinical biometrics, and combinations of markers.FindingsOf the 193 citations identified, 59 studies that evaluated over 112 host biomarkers were selected. Most studies involved patient populations from high-income countries, while 19% involved populations from low- and middle-income countries. The most frequently evaluated host biomarkers were C-reactive protein (61%), white blood cell count (44%) and procalcitonin (34%). Study quality scores ranged from 23.1% to 92.3%. There were 9 high performance host biomarkers or combinations, with sensitivity and specificity of ≥85% or either sensitivity or specificity was reported to be 100%. Five host biomarkers were considered weak markers as they lacked statistically significant performance in discriminating between bacterial and non-bacterial infections.DiscussionThis manuscript provides a summary of host biomarkers to differentiate bacterial from non-bacterial infections in patients with acute febrile illness. Findings provide a basis for prioritizing efforts for further research, assay development and eventual commercialization of rapid point-of-care tests to guide use of antimicrobials. This review also highlights gaps in current knowledge that should be addressed to further improve management of febrile patients.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Host Biomarkers for Distinguishing Bacterial from Non-Bacterial Causes of Acute Febrile Illness: A Comprehensive Review

et al. 2016

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“…The sensitivity and specificity of the CSF interleukin-8 concentration have been reported as a diagnostic marker for bacterial meningitis. [12][13][14] Furthermore, excessive inflammation in the central nervous system (CNS) can cause damage and seriously impair its function, and hence the association between CSF interleukin-8 concentrations and neurological outcomes has been previously studied. 15,16 Serum interleukin-10 may serve as a potential early diagnostic marker of infection and could improve the sensitivity and specificity of the early diagnosis of sepsis, and a significant increase of interleukin-10 gene expression has already been reported in patients with meningitis.…”

Section: Introductionmentioning

confidence: 99%

The combination of cerebrospinal fluid procalcitonin, lactate, interleukin-8 and interleukin-10 concentrations for the diagnosis of postneurosurgical bacterial meningitis: A prospective study

et al. 2018

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Background The differential diagnosis between postneurosurgical bacterial meningitis and aseptic meningitis remains challenging both for the clinician and the laboratory. Combinations of markers, as opposed to single ones, may improve diagnosis and thereby survival. Methods This prospective cohort study included patients with suspected bacterial meningitis after neurosurgery. The patients were divided into two groups according to the diagnostic criteria of meningitis involving a postneurosurgical bacterial meningitis group and a postneurosurgical aseptic meningitis group. Four biomarkers, including cerebrospinal fluid procalcitonin, lactate, interleukin-8 and interleukin-10 were assayed separately, and three algorithms were constructed using a linear combination. The area under the receiver operating characteristic curve was used to compare their performances. Results A cohort of 112 patients was enrolled in our study. Forty-three patients were diagnosed with postneurosurgical bacterial meningitis, and the cerebrospinal fluid values of their biomarkers were higher in patients with postneurosurgical bacterial meningitis than with postneurosurgical aseptic meningitis. The area under the receiver operating characteristic curves for the detection of postneurosurgical bacterial meningitis were 0.803 (95% confidence interval [CI], 0.724-0.883) for procalcitonin; 0.936 (95% CI, 0.895-0.977) for lactate; 0.771 (95% CI, 0.683-0.860) for interleukin-8; 0.860 (95% CI, 0.797-0.929) for interleukin-10; 0.937 (95% CI, 0.897-0.977) for the composite two-marker test; 0.945 (95% CI, 0.908-0.982) for the composite three-marker test and 0.954 (95% CI, 0.922-0.989) for the composite of all tests. The area under the receiver operating characteristic curves of the combination tests were greater than those of the single markers. Conclusions Combining information from several markers improved the diagnostic accuracy in detecting postneurosurgical bacterial meningitis.

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Pathophysiology of Neonatal Bacterial Meningitis

Barichello¹

2017

Fetal and Neonatal Physiology

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Role of Cerebrospinal Fluid Il-8 as a Marker for Differentiation between Acute Bacterial and Aseptic Meningitis

Cited by 6 publications

References 0 publications

Host Biomarkers for Distinguishing Bacterial from Non-Bacterial Causes of Acute Febrile Illness: A Comprehensive Review

Host Biomarkers for Distinguishing Bacterial from Non-Bacterial Causes of Acute Febrile Illness: A Comprehensive Review

The combination of cerebrospinal fluid procalcitonin, lactate, interleukin-8 and interleukin-10 concentrations for the diagnosis of postneurosurgical bacterial meningitis: A prospective study

Pathophysiology of Neonatal Bacterial Meningitis

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