Diagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort study
Abstract Background The early differential diagnosis between bacterial meningitis (BM) and tuberculous meningitis (TBM) or cryptococcal meningitis (CM) remains a significant clinical challenge. Neutrophil Gelatinase-Associated Lipocalin (NGAL) has been reported as a novel inflammatory biomarker in t...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of Translational Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12967-023-04485-w |
| _version_ | 1797451668829241344 |
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| author | Qi Wang Qingwen Lin Haiyan Wang Minjie Tang Kengna Fan Zeqin Zhang Er Huang Weiqing Zhang Fengqing Wang Qishui Ou Xiaofeng Liu |
| author_facet | Qi Wang Qingwen Lin Haiyan Wang Minjie Tang Kengna Fan Zeqin Zhang Er Huang Weiqing Zhang Fengqing Wang Qishui Ou Xiaofeng Liu |
| author_sort | Qi Wang |
| collection | DOAJ |
| description | Abstract Background The early differential diagnosis between bacterial meningitis (BM) and tuberculous meningitis (TBM) or cryptococcal meningitis (CM) remains a significant clinical challenge. Neutrophil Gelatinase-Associated Lipocalin (NGAL) has been reported as a novel inflammatory biomarker in the early stages of infection. This study aimed to investigate whether cerebrospinal fluid (CSF) NGAL can serve as a potential biomarker for distinguishing between BM and TBM or CM. Methods We prospectively enrolled the patients with suspected CNS infections at admission and divided them into three case groups: BM (n = 67), TBM (n = 55), CM (n = 51), and an age- and sex-matched hospitalized control (HC, n = 58). Detected the CSF NGAL and assessed its diagnostic accuracy in distinguishing between BM and TBM or CM. Additionally, longitudinally measured the CSF NGAL levels in patients with BM to evaluate its potential as a monitoring tool for antibacterial treatment. Results The concentration of CSF NGAL in BM was significantly higher than in TBM, CM, and HC (all P < 0.05), while the serum NGAL did not show significant differences among the three case groups. The ROC analysis demonstrated that CSF NGAL presented a good diagnostic performance with an AUC of 0.834 (0.770–0.886) and at the optimal cutoff value of 74.27 ng/mL with 70.15% sensitivity and 77.36% specificity for discriminating BM with TBM and CM. Additionally, the CSF NGAL in the convalescent period of BM was significantly lower than in the acute period (P < 0.05). Conclusions CSF NGAL may serve as a potential biomarker for distinguishing between acute BM and TBM or CM. Additionally, it holds clinical significance in monitoring the effectiveness of antibiotic therapy for BM. |
| first_indexed | 2024-03-09T14:57:49Z |
| format | Article |
| id | doaj.art-1d41cc8663934a91ae2825c38f4fdc10 |
| institution | Directory Open Access Journal |
| issn | 1479-5876 |
| language | English |
| last_indexed | 2024-03-09T14:57:49Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj.art-1d41cc8663934a91ae2825c38f4fdc102023-11-26T14:05:12ZengBMCJournal of Translational Medicine1479-58762023-09-0121111010.1186/s12967-023-04485-wDiagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort studyQi Wang0Qingwen Lin1Haiyan Wang2Minjie Tang3Kengna Fan4Zeqin Zhang5Er Huang6Weiqing Zhang7Fengqing Wang8Qishui Ou9Xiaofeng Liu10Department of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical UniversityAbstract Background The early differential diagnosis between bacterial meningitis (BM) and tuberculous meningitis (TBM) or cryptococcal meningitis (CM) remains a significant clinical challenge. Neutrophil Gelatinase-Associated Lipocalin (NGAL) has been reported as a novel inflammatory biomarker in the early stages of infection. This study aimed to investigate whether cerebrospinal fluid (CSF) NGAL can serve as a potential biomarker for distinguishing between BM and TBM or CM. Methods We prospectively enrolled the patients with suspected CNS infections at admission and divided them into three case groups: BM (n = 67), TBM (n = 55), CM (n = 51), and an age- and sex-matched hospitalized control (HC, n = 58). Detected the CSF NGAL and assessed its diagnostic accuracy in distinguishing between BM and TBM or CM. Additionally, longitudinally measured the CSF NGAL levels in patients with BM to evaluate its potential as a monitoring tool for antibacterial treatment. Results The concentration of CSF NGAL in BM was significantly higher than in TBM, CM, and HC (all P < 0.05), while the serum NGAL did not show significant differences among the three case groups. The ROC analysis demonstrated that CSF NGAL presented a good diagnostic performance with an AUC of 0.834 (0.770–0.886) and at the optimal cutoff value of 74.27 ng/mL with 70.15% sensitivity and 77.36% specificity for discriminating BM with TBM and CM. Additionally, the CSF NGAL in the convalescent period of BM was significantly lower than in the acute period (P < 0.05). Conclusions CSF NGAL may serve as a potential biomarker for distinguishing between acute BM and TBM or CM. Additionally, it holds clinical significance in monitoring the effectiveness of antibiotic therapy for BM.https://doi.org/10.1186/s12967-023-04485-wBacterial meningitisNeutrophil Gelatinase-Associated LipocalinCerebrospinal fluidDiagnostic biomarkerCentral nervous system infection |
| spellingShingle | Qi Wang Qingwen Lin Haiyan Wang Minjie Tang Kengna Fan Zeqin Zhang Er Huang Weiqing Zhang Fengqing Wang Qishui Ou Xiaofeng Liu Diagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort study Journal of Translational Medicine Bacterial meningitis Neutrophil Gelatinase-Associated Lipocalin Cerebrospinal fluid Diagnostic biomarker Central nervous system infection |
| title | Diagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort study |
| title_full | Diagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort study |
| title_fullStr | Diagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort study |
| title_full_unstemmed | Diagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort study |
| title_short | Diagnostic value of cerebrospinal fluid Neutrophil Gelatinase-Associated Lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis: a prospective cohort study |
| title_sort | diagnostic value of cerebrospinal fluid neutrophil gelatinase associated lipocalin for differentiation of bacterial meningitis from tuberculous meningitis or cryptococcal meningitis a prospective cohort study |
| topic | Bacterial meningitis Neutrophil Gelatinase-Associated Lipocalin Cerebrospinal fluid Diagnostic biomarker Central nervous system infection |
| url | https://doi.org/10.1186/s12967-023-04485-w |
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