Journal article
Value of lipocalin 2 as a potential biomarker for bacterial meningitis
- Abstract:
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OBJECTIVES: Central nervous system (CNS) infections are common causes of morbidity and mortality worldwide. We aimed to discover protein biomarkers that could rapidly and accurately identify the likely cause of the infections, essential for clinical management and improving outcome.
METHODS: We applied liquid chromatography tandem mass-spectrometry on 45 cerebrospinal fluid (CSF) samples from a cohort of adults with/without CNS infections to discover potential diagnostic biomarkers. We then validated the diagnostic performance of a selected biomarker candidate in an independent cohort of 364 consecutively treated adults with CNS infections admitted to a referral hospital in Vietnam.
RESULTS: In the discovery cohort, we identified lipocalin 2 (LCN2) as a potential biomarker of bacterial meningitis (BM) other than tuberculous meningitis. The analysis of the validation cohort showed that LCN2 could discriminate BM from other CNS infections (including tuberculous meningitis, cryptococcal meningitis and viral/antibody-mediated encephalitis), with the sensitivity: 0.88 (95% confident interval (CI): 0.77-0.94), the specificity: 0.91 (95%CI: 0.88-0.94) and the diagnostic odd ratio: 73.8 (95%CI: 31.8-171.4)). LCN2 outperformed other CSF markers (leukocytes, glucose, protein and lactate) commonly used in routine care worldwide. The combination of LCN2, CSF leukocytes, glucose, protein and lactate resulted in the highest diagnostic performance for BM (area under receiver-operating-characteristic-curve 0.96; 95%CI: 0.93-0.99).
CONCLUSIONS: Our results suggest that LCN2 is a sensitive and specific biomarker for discriminating BM from a broad spectrum of other CNS infections. A prospective study is needed to assess the diagnostic utility of LCN2 in the diagnosis and management of CNS infections.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 1.5MB, Terms of use)
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- Publisher copy:
- 10.1016/j.cmi.2020.07.006
Authors
- Publisher:
- Elsevier
- Journal:
- Clinical Microbiology and Infection More from this journal
- Volume:
- 27
- Issue:
- 5
- Pages:
- 724-730
- Publication date:
- 2020-07-10
- Acceptance date:
- 2020-07-04
- DOI:
- EISSN:
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1469-0691
- ISSN:
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1198-743X
- Language:
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English
- Keywords:
- Pubs id:
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1119235
- Local pid:
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pubs:1119235
- Deposit date:
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2020-07-16
Terms of use
- Copyright holder:
- TT Thanh et al.
- Copyright date:
- 2020
- Rights statement:
- ©2020 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY license.
- Licence:
- CC Attribution (CC BY)
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