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D- and L-lactate in rabbit and human bacterial meningitis

A Wellmer1, J Prange, J Gerber

  • 1Department of Neurology, University of Göttingen, Germany.

Scandinavian Journal of Infectious Diseases
|March 1, 2002
PubMed

Insights

Cerebrospinal fluid (CSF) lactate levels help distinguish bacterial from aseptic meningitis. However, D-lactate, produced by bacteria, is minimally present in human meningitis cases, indicating limited diagnostic value.

Area of Science:

  • Microbiology
  • Neurology
  • Biochemistry

Background:

  • Elevated cerebrospinal fluid (CSF) lactate is a key differentiator between bacterial and aseptic meningitis.
  • Bacteria produce both D- and L-lactate, while mammalian cells produce only L-lactate.

Purpose of the Study:

  • To investigate the production of D- and L-lactate by common bacterial meningitis pathogens in vitro and in vivo.
  • To assess the diagnostic utility of CSF D-lactate levels in differentiating bacterial meningitis.

Main Methods:

  • Measured D- and L-lactate production of Streptococcus pneumoniae, Staphylococcus aureus, Neisseria meningitidis, and Escherichia coli in vitro.
  • Analyzed lactate levels in rabbit experimental meningitis models (S. pneumoniae, E. coli).
  • Quantified D- and L-lactate in CSF samples from patients with bacterial meningitis.

Main Results:

  • Despite significant in vitro D-lactate production by S. aureus, N. meningitidis, and E. coli, minimal D-lactate was detected in human CSF samples from patients with S. aureus, N. meningitidis, or E. coli meningitis.
  • S. pneumoniae showed negligible D-lactate production in all experimental settings.
  • In only 9 out of 54 human CSF samples did D-lactate levels exceed 0.15 mmol/l.

Conclusions:

  • Increased total CSF lactate in meningitis primarily consists of L-lactate, predominantly originating from host cells.
  • CSF D-lactate levels are of limited diagnostic value for differentiating bacterial meningitis.

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