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Role of beta-2-microglobulin as a biomarker in very preterm and extremely preterm infants with CNS inflammation

Albert Batista Muñoz1, Stephanie Hadley2, Marti Iriondo Sanz1

  • 1BCNatal | Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, Esplugues de Llobregat, Spain.

Plos One
|May 8, 2019
PubMed
Abstract

Insights

Cerebrospinal fluid beta-2-microglobulin (B2M) effectively identifies central nervous system infections in preterm infants. Elevated B2M levels are more sensitive and specific than leukocytes for diagnosing these serious conditions.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Biomarker Research

Background:

  • Premature infants face high risks of sepsis and meningitis, leading to significant mortality and morbidity.
  • Accurate diagnosis of central nervous system (CNS) infections in neonates is critical for timely treatment.
  • Cerebrospinal fluid (CSF) analysis is key, but biochemical markers need further validation.

Purpose of the Study:

  • To investigate elevated CSF beta-2-microglobulin (B2M) levels in preterm infants with CNS infections or inflammatory conditions.
  • To differentiate B2M concentrations across various inflammatory settings like sepsis, meningitis, and post-hemorrhagic ventricular dilatation (PHVD).

Main Methods:

  • Retrospective study of very and extremely preterm infants (< 32 weeks gestation) admitted between 2012-2017.
  • Inclusion criteria: lumbar puncture for sepsis work-up or PHVD.
  • Analysis of CSF biochemical parameters and B2M levels in all included patients.

Main Results:

  • Fifty-nine preterm infants were included in the analysis.
  • Median B2M levels were 8.69 mg/L in infants with CNS infections.
  • B2M levels > 3.92 mg/L demonstrated superior sensitivity and specificity compared to leukocytes in distinguishing CNS inflammation.

Conclusions:

  • CSF B2M is a valuable biomarker for differentiating CNS infections from other inflammatory processes in preterm infants.
  • B2M aids in distinguishing inflammatory conditions from non-inflammatory states in this vulnerable population.

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