Open AccessDiagnostic 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
Author(s) -
Sibel Yorulmaz Göktaş,
Arzu Yılmaztepe Oral,
Emel Yılmaz,
Halis Akalın,
Furkan Guvenc,
Güven Özkaya,
Hasan Kocaelı,
Şeref Doğan,
Selçuk Yılmazlar,
Haluk Barbaros Oral
Publication year - 2021
Publication title -
singapore medical journal/singapore medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.452
H-Index - 61
eISSN - 2737-5935
pISSN - 0037-5675
DOI - 10.11622/smedj.2021123
Subject(s) - pleocytosis , meningitis , medicine , cerebrospinal fluid , csf pleocytosis , gastroenterology , tumor necrosis factor alpha , immunology , surgery
This 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. Methods: CSF 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. Results: CSF 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 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). Conclusion: In our study, we have concluded that IL-6, IL-8 and D-lactate levels could be diagnostic markers for nosocomial meningitis.