Show simple item record

dc.contributor.authorde Araujo, Leonardo Silva
dc.contributor.authorPessler, Kevin
dc.contributor.authorSühs, Kurt-Wolfram
dc.contributor.authorNovoselova, Natalia
dc.contributor.authorKlawonn, Frank
dc.contributor.authorKuhn, Maike
dc.contributor.authorKaever, Volkhard
dc.contributor.authorMüller-Vahl, Kirsten
dc.contributor.authorTrebst, Corinna
dc.contributor.authorSkripuletz, Thomas
dc.contributor.authorStangel, Martin
dc.contributor.authorPessler, Frank
dc.date.accessioned2020-01-17T13:46:03Z
dc.date.available2020-01-17T13:46:03Z
dc.date.issued2020-01-07
dc.identifier.citationJ Transl Med. 2020 Jan 7;18(1):9. doi: 10.1186/s12967-019-02179-w.en_US
dc.identifier.issn1479-5876
dc.identifier.pmid31910875
dc.identifier.doi10.1186/s12967-019-02179-w
dc.identifier.urihttp://hdl.handle.net/10033/622091
dc.description.abstractBACKGROUND: The timely diagnosis of bacterial meningitis is of utmost importance due to the need to institute antibiotic treatment as early as possible. Moreover, the differentiation from other causes of meningitis/encephalitis is critical because of differences in management such as the need for antiviral or immunosuppressive treatments. Considering our previously reported association between free membrane phospholipids in cerebrospinal fluid (CSF) and CNS involvement in neuroinfections we evaluated phosphatidylcholine PC ae C44:6, an integral constituent of cell membranes, as diagnostic biomarker for bacterial meningitis. METHODS: We used tandem mass spectrometry to measure concentrations of PC ae C44:6 in cell-free CSF samples (n = 221) from patients with acute bacterial meningitis, neuroborreliosis, viral meningitis/encephalitis (herpes simplex virus, varicella zoster virus, enteroviruses), autoimmune neuroinflammation (anti-NMDA-receptor autoimmune encephalitis, multiple sclerosis), facial nerve and segmental herpes zoster (shingles), and noninflammatory CNS disorders (Bell's palsy, Tourette syndrome, normal pressure hydrocephalus). RESULTS: PC ae C44:6 concentrations were significantly higher in bacterial meningitis than in all other diagnostic groups, and were higher in patients with a classic bacterial meningitis pathogen (e.g. Streptococcus pneumoniae, Neisseria meningitidis, Staphylococcus aureus) than in those with less virulent or opportunistic pathogens as causative agents (P = 0.026). PC ae C44:6 concentrations were only moderately associated with CSF cell count (Spearman's ρ = 0.45; P = 0.009), indicating that they do not merely reflect neuroinflammation. In receiver operating characteristic curve analysis, PC ae C44:6 equaled CSF cell count in the ability to distinguish bacterial meningitis from viral meningitis/encephalitis and autoimmune CNS disorders (AUC 0.93 both), but had higher sensitivity (91% vs. 41%) and negative predictive value (98% vs. 89%). A diagnostic algorithm comprising cell count, lactate and PC ae C44:6 had a sensitivity of 97% (specificity 87%) and negative predictive value of 99% (positive predictive value 61%) and correctly diagnosed three of four bacterial meningitis samples that were misclassified by cell count and lactate due to low values not suggestive of bacterial meningitis. CONCLUSIONS: Increased CSF PC ae C44:6 concentrations in bacterial meningitis likely reflect ongoing CNS cell membrane stress or damage and have potential as additional, sensitive biomarker to diagnose bacterial meningitis in patients with less pronounced neuroinflammation.en_US
dc.language.isoenen_US
dc.publisherBioMed Central (BMC)en_US
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/*
dc.subjectBiomarkeren_US
dc.subjectBrainen_US
dc.subjectDiagnosisen_US
dc.subjectEncephalitisen_US
dc.subjectInfectionen_US
dc.subjectLecithinen_US
dc.subjectLipidomicsen_US
dc.subjectLipidsen_US
dc.subjectMeningitisen_US
dc.subjectMetabolomicsen_US
dc.titlePhosphatidylcholine PC ae C44:6 in cerebrospinal fluid is a sensitive biomarker for bacterial meningitis.en_US
dc.typeArticleen_US
dc.contributor.departmentTWINCORE, Zentrum für experimentelle und klinische Infektionsforschung GmbH,Feodor-Lynen Str. 7, 30625 Hannover, Germany.en_US
dc.identifier.journall: Journal of Translational Medicineen_US
refterms.dateFOA2020-01-17T13:46:04Z
dc.source.journaltitleJournal of translational medicine


Files in this item

Thumbnail
Name:
de Araujo et al..pdf
Size:
1.499Mb
Format:
PDF
Description:
Open Access publication

This item appears in the following Collection(s)

Show simple item record

Attribution-NonCommercial-ShareAlike 4.0 International
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-ShareAlike 4.0 International