Document Detail

Heparin-binding protein: a diagnostic marker of acute bacterial meningitis.
MedLine Citation:
PMID:  21200320     Owner:  NLM     Status:  MEDLINE    
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.
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.
Adam Linder; Per Akesson; Magnus Brink; Marie Studahl; Lars Björck; Bertil Christensson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  39     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-05-25     Completed Date:  2011-07-29     Revised Date:  2011-10-24    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  812-7     Citation Subset:  AIM; IM    
Department of Clinical Sciences, Division of Infection Medicine, Lund University Hospital, Lund, Sweden.
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MeSH Terms
Aged, 80 and over
Antimicrobial Cationic Peptides / cerebrospinal fluid*
Biological Markers / cerebrospinal fluid
Blood Proteins / cerebrospinal fluid*
Carrier Proteins / cerebrospinal fluid*
Encephalitis, Viral / cerebrospinal fluid,  diagnosis
Leukocyte Count
Meningitis, Bacterial / cerebrospinal fluid,  diagnosis*,  microbiology
Meningitis, Viral / cerebrospinal fluid,  diagnosis
Middle Aged
Prospective Studies
ROC Curve
Retrospective Studies
Statistics, Nonparametric
Young Adult
Reg. No./Substance:
0/Antimicrobial Cationic Peptides; 0/Biological Markers; 0/Blood Proteins; 0/Carrier Proteins; 0/cationic antimicrobial protein CAP 37, human
Comment In:
Crit Care Med. 2011 Oct;39(10):2383-4; author reply 2384-5   [PMID:  21926508 ]
Crit Care Med. 2011 Apr;39(4):910-1   [PMID:  21613851 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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