Youran Li
Capital Medical University,China
Title: The diagnostic value of cerebrospinal fluids procalcitonin and lactate for the differential diagnosis of post-neurosurgical bacterial meningitis and aseptic meningitis
Biography
Biography: Youran Li
Abstract
Objectives: Distinguishing between post-neurosurgical bacterial meningitis (PNBM) and aseptic meningitis is difficult. This study aims to evaluate the combined diagnostic value of CSF procalcitonin and lactate as novel PNBM markers in hospitalized post-neurosurgery patients. Design and methods: This study was performed using CSF samples, collected by lumbar puncture, from178 PNBM-suspected patients enrolled in a retrospective clinical study. The levels of CSF procalcitonin and lactate were appropriately assayed and the combined diagnostic value of these markers was assessed using receiver operating characteristic (ROC) curves, a two by two table, and non-parametric tests. Results: Fifty of the 178 patientswere diagnosed with PNBM, based on the clinical symptoms and laboratory results. These PNBMpatients showed significantly elevated levels of CSF procalcitonin and CSF lactate compared with the non-PNBMgroup (p b 0.001 for both). It was revealed that the cut-off values for the diagnosis of PNBM were: 0.075 ng/mL (sensitivity, 68%; specificity, 73%) for procalcitonin and 3.45 mmol/L (sensitivity, 90%; specificity, 85%) for lactate. A serial test combining the levels of these two markers showed decreased sensitivity (64%) and increased specificity (91%), compared with either marker alone. In contrast, a parallel test combining the levels of these both markers showed increased sensitivity (96%) and decreased specificity (65%), compared with either marker alone. Conclusion: Our study shows that the combined use of CSF procalcitonin and lactate can reliably distinguish between PNBM and non-PNBM and can be included in the design of diagnostic approaches to circumvent the shortcomings of conventional methods.