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Objective: Cerebrovascular impairment and secondary inflammatory responses are important in bacterial meningitis-associated brain damage. The purpose of the study was to evaluate matrix metalloproteinase-9 (MMP-9) as a marker for brain damage in bacterial meningitis. Materials: The subjects were 31 pediatric patients, including 12 with bacterial meningitis, 12 with aseptic meningitis, and 7 with other infections of the central nervous system. Methods: Several potential markers, including MMP-9 in cerebrospinal fluid (CSF), were measured in all the pediatric patients. Results: Children with bacterial meningitis had a significantly higher level of CSF MMP-9 compared to those with other diseases aseptic meningitis and encephalitis/encephalopathy. CSF levels of MMP-9 in the 6 patients without complications markedly decreased in the recovery phase, while those of the 6 patients with complications remained high or re-elevated. CSF MMP-9 in the recovery phase was significantly higher (p<0.01) in patients with complications. Conclusion: The CSF MMP-9 level may be a useful prognostic marker in pediatric patients with bacterial meningitis.

Cerebrospinal Fluid Matrix Metalloproteinase-9 Level in Children with Bacterial Meningitis