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Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells
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Elevations of novel cytokines in bacterial meningitis in infants

Lakshmi Srinivasan1,2, Laurie Kilpatrick3, Samir S Shah4,5

  • 1Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America.

Plos One
|February 3, 2018
PubMed
Abstract

Insights

New biomarkers, including Interleukin-23 (IL-23), show high accuracy in diagnosing bacterial meningitis in infants, even after antibiotic treatment. These markers can aid clinical decisions.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Diagnostics
  • Biomarker Discovery

Background:

  • Bacterial meningitis diagnosis in infants is difficult, especially with prior antibiotic use.
  • Cerebrospinal fluid (CSF) culture yields are often reduced by pre-treatment.
  • Existing diagnostic markers lack sufficient accuracy for bacterial meningitis.

Purpose of the Study:

  • To evaluate Interleukin-23 (IL-23), Interleukin-18 (IL-18), and soluble receptor for advanced glycation end products (sRAGE) as diagnostic markers for bacterial meningitis in infants.
  • To assess the diagnostic accuracy of these novel biomarkers, individually and in combination.

Main Methods:

  • A prospective cohort study involving 189 infants under 6 months.
  • Measurement of IL-23, IL-18, and sRAGE levels in CSF.
  • Receiver operating characteristic (ROC) analyses to determine diagnostic accuracy.

Main Results:

  • CSF levels of IL-23, IL-18, and sRAGE were significantly elevated in infants with bacterial meningitis.
  • IL-23 demonstrated the highest individual diagnostic accuracy (AUC 0.9698).
  • The combination of all three markers achieved a perfect AUC of 1.

Conclusions:

  • IL-23, IL-18, and sRAGE are highly accurate biomarkers for diagnosing bacterial meningitis in infants.
  • These markers, particularly IL-23, can assist clinicians in diagnosis and treatment decisions.
  • Further validation may lead to improved management of infant bacterial meningitis.

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