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Updated: Nov 2, 2025
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Microbial aspects and potential markers for differentiation between bacterial and viral meningitis among adult
Sultan F Alnomasy1, Bader S Alotaibi1, Ahmed H Mujamammi2
1Department of Medical Laboratories Sciences, College of Applied Medical Sciences in Al- Quwayiyah, Shaqra University, Al- Quwayiyah, Riyadh, Saudi Arabia.
Objectives:
Meningitis is a medical emergency with permanent disabilities and high mortality worldwide. We aimed to determine causative microorganisms and potential markers for differentiation between bacterial and viral meningitis.
Methodology:
Adult patients with acute meningitis were subjected to lumber puncture. Cerebrospinal fluid (CSF) microorganisms were identified using Real-time PCR. PCT and CRP levels, peripheral and CSF-leucocyte count, CSF-protein and CSF-glucose levels were assessed.
Results:
Out of 80 patients, infectious meningitis was confirmed in 75 cases; 38 cases were bacterial meningitis, 34 cases were viral meningitis and three cases were mixed infection. Higher PCT, peripheral and CSF-leukocytosis, higher CSF-protein and lower CSF-glucose levels were more significant in bacterial than viral meningitis patients. Neisseria meningitides was the most frequent bacteria and varicella-zoster virus was the most common virus. Using ROC analyses, serum PCT and CSF-parameters can discriminate bacterial from viral meningitis. Combined ROC analyses of PCT and CSF-protein significantly improved the effectiveness in predicting bacterial meningitis (AUC of 0.998, 100%sensitivity and 97.1%specificity) than each parameter alone (AUC of 0.951 for PCT and 0.996 for CSF-protein).
Conclusion:
CSF-protein and serum PCT are considered as potential markers for differentiating bacterial from viral meningitis and their combination improved their predictive accuracy to bacterial meningitis.
Insights
This study identified key markers to differentiate bacterial from viral meningitis. Combining cerebrospinal fluid (CSF) protein and serum procalcitonin (PCT) levels offers high accuracy in predicting bacterial meningitis.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Biomarker Discovery
Background:
- Meningitis is a critical condition with high mortality and potential for permanent disability.
- Accurate differentiation between bacterial and viral meningitis is crucial for timely and appropriate treatment.
Purpose of the Study:
- To identify causative microorganisms in meningitis.
- To determine potential biomarkers for distinguishing bacterial from viral meningitis.
Main Methods:
- Adult patients with acute meningitis underwent lumbar puncture for cerebrospinal fluid (CSF) analysis.
- Real-time PCR was used to identify microorganisms in CSF.
- Procalcitonin (PCT), C-reactive protein (CRP), leucocyte counts, and CSF-protein and glucose levels were assessed.
Main Results:
- Of 80 patients, 75 had confirmed meningitis (38 bacterial, 34 viral, 3 mixed).
- Bacterial meningitis showed significantly higher PCT, leucocyte counts, and CSF-protein, with lower CSF-glucose compared to viral meningitis.
- Serum PCT and CSF parameters, particularly the combination of PCT and CSF-protein, demonstrated high accuracy (AUC 0.998) in differentiating bacterial from viral meningitis.
Conclusions:
- Cerebrospinal fluid (CSF) protein and serum procalcitonin (PCT) are valuable markers for differentiating bacterial from viral meningitis.
- The combined use of CSF-protein and serum PCT significantly enhances the accuracy of predicting bacterial meningitis.
