• Singap Med J · Oct 2021

    Diagnostic value of the CSF levels of D-Lactate and pro-inflammatory cytokines (TNF-alpha, IL-6, IL-8 and IL-17) in the patients with suspected nosocomial meningitis.

    • GoktasSibel YorulmazSY0000-0003-1168-7453Department of Infectious Diseases and Clinical Microbiology, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey., Arzu Yılmaztepe Oral, Emel Yılmaz, Emin Halis Akalın, Furkan Guvenc, Guven Ozkaya, Hasan Kocaeli, Seref Dogan, Selcuk Yılmazlar, and Haluk Barbaros Oral.
    • Department of Infectious Diseases and Clinical Microbiology, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
    • Singap Med J. 2021 Oct 3.

    IntroductionThis study aims to determine the diagnostic value of IL-6, IL-8, IL-17, TNF-α and D-lactate levels in the cerebrospinal fluid (CSF) in nosocomial meningitis.MethodsCSF levels of cytokines and D-lactate were compared across 29 episodes who were diagnosed with nosocomial meningitis, 38 episodes with pleocytosis but without meningitis and 54 control subjects.ResultsCSF levels of IL-6, IL-8, and D-lactate were higher in the group with nosocomial meningitis compared to the control group and to the group with pleocytosis without meningitis (p<0.05). For the levels of IL-6, when the threshold was considered to be > 440 pg/mL, the sensitivity and specificity were 55.17% and 94.74%, respectively. For IL-8 levels, when the threshold was considered to be >1249 pg/mL, the sensitivity and specificity were 44.83% and 84.21%, respectively. In the patients with nosocomial meningitis, when the threshold of D-lactate levels was considered to be >1.05µmol/mL, the sensitivity and specificity were found to be 75.86% and 63.16%, respectively. In the pleocytosis without meningitis CSF samples and in the CSF samples diagnosed with nosocomial meningitis, the highest AUC was calculated for triple combination model of IL-6, IL-8, and D-lactate levels (AUC= 0.801, p<0.001), and double combination model IL-6 and IL-8 (AUC= 0.790) (p<0.001).ConclusionIn our study, we have concluded that IL-6, IL-8 and D-lactate levels could be diagnostic markers for nosocomial meningitis.

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