Reshi Z, Nazir M, Wani W, Malik M, Iqbal J, Wajid S.
Cerebrospinal fluid procalcitonin as a biomarker of bacterial meningitis in
neonates. J Perinatol. 2017 May 25. doi: 10.1038/jp.2017.73. [Epub ahead of print]
Abstract
OBJECTIVE:
The objective of the study was to study the performance of
cerebrospinal fluid (CSF) procalcitonin as a marker for bacterial meningitis in
neonates, and to determine its optimal 'cutoff' in CSF that can be called
significant for the diagnosis.
STUDY DESIGN:
Neonates qualifying for lumbar puncture were prospectively
studied. Procalcitonin and established CSF parameters were recorded.
RESULTS:
At a cut-off value of 0.33 ng ml-1, CSF procalcitonin had a
sensitivity of 0.92, specificity of 0.87, with positive and negative likelihood
ratios of 7.13 and 0.092, respectively. The area under the curve for different
CSF parameters was: 0.926 (0.887 to 0.964) (P<0.001) for procalcitonin,
0.965 (0.956 to 0.974) for total leukocyte count, 0.961 (0.94 to 0.983) for
neutrophil count, 0.874 (0.825 to 0.923) for protein, 0.946 (0.914 to 0.978)
for sugar and 0.92 (0.955 to 0.992) for CSF:serum sugar ratio. The lumbar
puncture was traumatic in 36 (21.4%) patients; out of these 15 (41.7%) had
bacterial meningitis and 21 (58.3%) had no meningitis. In traumatic lumbar tap
group, the median (IQR) CSF procalcitonin in patients with and without
meningitis was 1.41 (0.32-3.42) ng/ml and 0.21(0.20-0.31) ng/ml respectively
(p<0.05).
CONCLUSIONS:
Procalcitonin measurement has diagnostic efficiency similar
to the established CSF markers. Routine assessment of procalcitonin in clean
non-contaminated CSF may not yield additional information, but it may have
clinical utility in situations where diagnosis of meningitis is in dilemma, as
in the case of blood contamination of CSF in traumatic lumbar punctures.
Courtesy of: https://www.mdlinx.com/neurology/medical-news-article/2017/05/30/bacterial-meningitis-neonates-procalcitonin/7190689/?category=latest&page_id=2
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