| Heparin-binding protein: a diagnostic marker of acute bacterial meningitis. | |
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MedLine Citation:
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PMID: 21200320 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Adam Linder; Per Akesson; Magnus Brink; Marie Studahl; Lars Björck; Bertil Christensson |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 39 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-05-25 Completed Date: 2011-07-29 Revised Date: 2011-10-24 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 812-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Clinical Sciences, Division of Infection Medicine, Lund University Hospital, Lund, Sweden. adam.linder@med.lu.se |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged 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 Female Humans Leukocyte Count Male Meningitis, Bacterial / cerebrospinal fluid, diagnosis*, microbiology Meningitis, Viral / cerebrospinal fluid, diagnosis Middle Aged Prospective Studies ROC Curve Retrospective Studies Statistics, Nonparametric Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antimicrobial Cationic Peptides; 0/Biological Markers; 0/Blood Proteins; 0/Carrier Proteins; 0/cationic antimicrobial protein CAP 37, human |
| Comments/Corrections | |
Comment In:
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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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