1004. Are New Biomarkers Useful in the Diagnosis of Meningitis in Adults?
Session: Poster Abstract Session: Adult CNS Infection
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • Are New Biomarkers Useful in the Diagnosis of Meningitis in Adults.pdf (420.3 kB)
  • Background:

    Meningitis is infection of the central nervous system with high mortality and morbidity in adults. Markers for diagnostic purposes can therefore be useful guides in differential diagnosis. Procalcitonin (PCT), platelet distribution width (PDW) and red blood cell distribution width (RDW) can be easily calculated with automated blood systems, and have been regarded as biomarkers showing inflammation in infection-related diseases. The purpose of this study was to determine the diagnostic significance of these biomarkers in adult meningitis.

    Methods:

    This study was a retrospective investigation. Diagnosis of meningitis was based on clinical findings and microbiological and biochemical investigations of CSF specimens. Patients’ white blood cell count (WBC), C-reactive protein (CRP), PDW, RDW and PCT levels at time of presentation were compared. p<0.05 was regarded as statistically significant.

     Results:

    137 patients were assessed. 95 patients had acute bacterial meningitis (ABM), 17 had aseptic meningitis (AM) and 25 had chronic meningitis (CM). When patients were evaluated by age, AMB was more common in the elderly and AM in the young (p<0.05). CRP and PCT levels at presentation were significantly higher in AM than in AM and CM (p<0.05). WBC levels differed statistically significantly between ABM and CM (p<0.05). PDW levels were significantly higher in AM then in CM (p<0.05). RDW was statistically significantly higher in CM than in ABM and AM (p<0.05). When ROC analysis was performed to differentiate ABM from the other forms (table). Correlation analysis between CSF biochemistry and biomarkers revealed that PCT was positively correlated with CRP, PDW and CSF protein and negatively correlated with CSF glucose.

    Table: ROC analysis for PCT, CRP and WBC in subjects with ABM

    Biomarker

    Cut-off

    AUC

    Sensitivity

    Specificity

    PPV

    NPV

    P

    PCT

    0.9

    0.713

    56.3

    86.1

    90.7

    44.9

    <0.001

    CRP

    2.2

    0.740

    76.8

    64.3

    83.0

    55.1

    <0.001

    WBC

    14400

    0.647

    34.7

    92.9

    91.7

    38.6

    0.002

    Conclusion:

    Our results suggest that PCT and CRP have diagnostic characteristics in favor of ABM at differential diagnosis in cases in which LP is contraindicated and/or CSF examination cannot be performed immediately or the agent cannot be identified. WBC and RDW can be useful guides in differentiating ABM from CM, and PDW and RDW in differentiating CM from ABM and AM.

    Firdevs Aksoy, Assistant Professor1, Gürdal Yilmaz, Professor1, Nurten Nur Aydin, Assistant doctor1, Selcuk Kaya, Associate Professor1, Süleyman Caner Karahan, Professor2 and Iftihar Koksal, Professor1, (1)Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, Medical Faculty, Trabzon, Turkey, (2)Department of Medical Biochemistry,, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey

    Disclosures:

    F. Aksoy, None

    G. Yilmaz, None

    N. N. Aydin, None

    S. Kaya, None

    S. C. Karahan, None

    I. Koksal, None

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