Advanced

Heparin-binding protein: A diagnostic marker of acute bacterial meningitis. : a diagnostic marker of acute bacterial meningitis

Linder, Adam LU ; Åkesson, Per LU ; Brink, Magnus; Studahl, Marie; Björck, Lars LU and Christensson, Bertil LU (2011) In Critical Care Medicine 39(4). p.812-817
Abstract

BACKGROUND: The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis.

OBJECTIVE: In this study we investigated whether heparin-binding protein levels in cerebrospinal fluid could be used as a diagnostic marker for acute bacterial meningitis.

DESIGN: One prospective and one retrospective patient cohort from two university hospitals in Sweden were analyzed.

SETTING AND PATIENTS: Cerebrospinal fluid samples were collected from 174 patients with suspected central nervous system infection. Thirty-seven patients with acute community-acquired bacterial meningitis, four... (More)

BACKGROUND: The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis.

OBJECTIVE: In this study we investigated whether heparin-binding protein levels in cerebrospinal fluid could be used as a diagnostic marker for acute bacterial meningitis.

DESIGN: One prospective and one retrospective patient cohort from two university hospitals in Sweden were analyzed.

SETTING AND PATIENTS: Cerebrospinal fluid samples were collected from 174 patients with suspected central nervous system infection. Thirty-seven patients with acute community-acquired bacterial meningitis, four patients with neurosurgical bacterial meningitis, 29 patients with viral meningitis or encephalitis, seven patients with neuroborreliosis, and 97 control patients were included.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Cerebrospinal fluid samples were analyzed for the concentrations of heparin-binding protein, lactate, protein, glucose, neutrophils, and mononuclear cells. Heparin-binding protein levels were significantly higher (p < .01) in patients with acute bacterial meningitis (median 376 ng/mL, range 12-858 ng/mL) than in patients with viral central nervous system infection (median 4.7 ng/mL, range 3.0-41 ng/mL) or neuroborreliosis (median 3.6 ng/mL, range 3.2-10 ng/mL) or in control patients with a normal cerebrospinal fluid cell count (median 3.5 ng/mL, range 2.4-8.7 ng/mL). In the prospectively studied group, a heparin-binding protein concentration exceeding 20 ng/mL gave a sensitivity of 100%, a specificity of 99.2%, and positive and negative predictive values of 96.2% and 100%, respectively, in diagnosing acute bacterial meningitis. The area under the receiver-operating characteristic curve for heparin-binding protein was 0.994, which was higher than for the other investigated parameters.

CONCLUSION: Elevated cerebrospinal fluid levels of heparin-binding protein distinguish between patients with acute bacterial meningitis and patients with other central nervous system infections.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescent, Adult, Aged, Aged, 80 and over, Antimicrobial Cationic Peptides, Biomarkers, Blood Proteins, Carrier Proteins, Encephalitis, Viral, Female, Humans, Leukocyte Count, Male, Meningitis, Bacterial, Meningitis, Viral, Middle Aged, Prospective Studies, ROC Curve, Retrospective Studies, Statistics, Nonparametric, Young Adult, Journal Article, Research Support, Non-U.S. Gov't
in
Critical Care Medicine
volume
39
issue
4
pages
6 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • WOS:000288533000028
  • PMID:21200320
  • Scopus:79953203890
ISSN
1530-0293
DOI
10.1097/CCM.0b013e318206c396http://dx.doi.org/10.1097/CCM.0b013e318206c396
language
English
LU publication?
yes
id
0e518159-1673-45cc-98eb-627dcf65f251 (old id 1777856)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21200320?dopt=Abstract
date added to LUP
2011-02-01 10:27:25
date last changed
2016-10-31 09:25:33
@misc{0e518159-1673-45cc-98eb-627dcf65f251,
  abstract     = {<p>BACKGROUND: The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis.</p><p>OBJECTIVE: In this study we investigated whether heparin-binding protein levels in cerebrospinal fluid could be used as a diagnostic marker for acute bacterial meningitis.</p><p>DESIGN: One prospective and one retrospective patient cohort from two university hospitals in Sweden were analyzed.</p><p>SETTING AND PATIENTS: Cerebrospinal fluid samples were collected from 174 patients with suspected central nervous system infection. Thirty-seven patients with acute community-acquired bacterial meningitis, four patients with neurosurgical bacterial meningitis, 29 patients with viral meningitis or encephalitis, seven patients with neuroborreliosis, and 97 control patients were included.</p><p>INTERVENTIONS: None.</p><p>MEASUREMENTS AND MAIN RESULTS: Cerebrospinal fluid samples were analyzed for the concentrations of heparin-binding protein, lactate, protein, glucose, neutrophils, and mononuclear cells. Heparin-binding protein levels were significantly higher (p &lt; .01) in patients with acute bacterial meningitis (median 376 ng/mL, range 12-858 ng/mL) than in patients with viral central nervous system infection (median 4.7 ng/mL, range 3.0-41 ng/mL) or neuroborreliosis (median 3.6 ng/mL, range 3.2-10 ng/mL) or in control patients with a normal cerebrospinal fluid cell count (median 3.5 ng/mL, range 2.4-8.7 ng/mL). In the prospectively studied group, a heparin-binding protein concentration exceeding 20 ng/mL gave a sensitivity of 100%, a specificity of 99.2%, and positive and negative predictive values of 96.2% and 100%, respectively, in diagnosing acute bacterial meningitis. The area under the receiver-operating characteristic curve for heparin-binding protein was 0.994, which was higher than for the other investigated parameters.</p><p>CONCLUSION: Elevated cerebrospinal fluid levels of heparin-binding protein distinguish between patients with acute bacterial meningitis and patients with other central nervous system infections.</p>},
  author       = {Linder, Adam and Åkesson, Per and Brink, Magnus and Studahl, Marie and Björck, Lars and Christensson, Bertil},
  issn         = {1530-0293},
  keyword      = {Adolescent,Adult,Aged,Aged, 80 and over,Antimicrobial Cationic Peptides,Biomarkers,Blood Proteins,Carrier Proteins,Encephalitis, Viral,Female,Humans,Leukocyte Count,Male,Meningitis, Bacterial,Meningitis, Viral,Middle Aged,Prospective Studies,ROC Curve,Retrospective Studies,Statistics, Nonparametric,Young Adult,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {4},
  pages        = {812--817},
  publisher    = {ARRAY(0x85740b8)},
  series       = {Critical Care Medicine},
  title        = {Heparin-binding protein: A diagnostic marker of acute bacterial meningitis. : a diagnostic marker of acute bacterial meningitis},
  url          = {http://dx.doi.org/10.1097/CCM.0b013e318206c396http://dx.doi.org/10.1097/CCM.0b013e318206c396},
  volume       = {39},
  year         = {2011},
}