Heparin-binding protein: A diagnostic marker of acute bacterial meningitis

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Linder, Adam (författare)

Heparin-binding protein: A diagnostic marker of acute bacterial meningitis

Artikel/kapitelEngelska2011

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2011

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LIBRIS-ID:oai:gup.ub.gu.se/151006
https://gup.ub.gu.se/publication/151006URI
https://doi.org/10.1097/CCM.0b013e318206c396DOI

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Språk:engelska

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BACKGROUND: The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis. OBJECTIVE: In this study we investigated whether heparin-binding protein levels in cerebrospinal fluid could be used as a diagnostic marker for acute bacterial meningitis. DESIGN: One prospective and one retrospective patient cohort from two university hospitals in Sweden were analyzed. SETTING AND PATIENTS: Cerebrospinal fluid samples were collected from 174 patients with suspected central nervous system infection. Thirty-seven patients with acute community-acquired bacterial meningitis, four patients with neurosurgical bacterial meningitis, 29 patients with viral meningitis or encephalitis, seven patients with neuroborreliosis, and 97 control patients were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Cerebrospinal fluid samples were analyzed for the concentrations of heparin-binding protein, lactate, protein, glucose, neutrophils, and mononuclear cells. Heparin-binding protein levels were significantly higher (p < .01) in patients with acute bacterial meningitis (median 376 ng/mL, range 12-858 ng/mL) than in patients with viral central nervous system infection (median 4.7 ng/mL, range 3.0-41 ng/mL) or neuroborreliosis (median 3.6 ng/mL, range 3.2-10 ng/mL) or in control patients with a normal cerebrospinal fluid cell count (median 3.5 ng/mL, range 2.4-8.7 ng/mL). In the prospectively studied group, a heparin-binding protein concentration exceeding 20 ng/mL gave a sensitivity of 100%, a specificity of 99.2%, and positive and negative predictive values of 96.2% and 100%, respectively, in diagnosing acute bacterial meningitis. The area under the receiver-operating characteristic curve for heparin-binding protein was 0.994, which was higher than for the other investigated parameters. CONCLUSION: Elevated cerebrospinal fluid levels of heparin-binding protein distinguish between patients with acute bacterial meningitis and patients with other central nervous system infections.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Mikrobiologi inom det medicinska området hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Microbiology in the medical area hsv//eng
bacterial meningitis
heparin-binding protein
vascular leakage

Biuppslag (personer, institutioner, konferenser, titlar ...)

Åkesson, Per (författare)
Brink, Magnus,1960Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine (författare)
Studahl, Marie,1957Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine(Swepub:gu)xstuma (författare)
Björck, Lars (författare)
Christensson, Bertil (författare)
Göteborgs universitetInstitutionen för medicin (creator_code:org_t)

Sammanhörande titlar

Ingår i:Critical Care Medicine39:4, s. 812-8170090-3493

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Av författaren/redakt...: Linder, Adam; Åkesson, Per; Brink, Magnus, 1 ...; Studahl, Marie, ...; Björck, Lars; Christensson, Be ...

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