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A pilot study for evaluating the feasibility of using alpha-defensin to support the diagnosis of ventriculitis
1The Doub Laboratory of Translational Bacterial Research, University of Maryland School of Medicine, Baltimore, USA; Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA.
Objectives:
Nosocomial ventriculitis is a difficult infectious condition to diagnose given that typical cerebral spinal fluid (CSF) parameters, commonly used in the diagnosis of meningitis, lack sensitivity and specificity in nosocomial ventriculitis. Consequently, novel diagnostics are needed to aid in diagnosing this condition. Herein a pilot study using alpha-defensins (α-defensins) to diagnose ventriculitis is discussed.
Methods:
From May 01, 2022, to December 30, 2022, ten patients with culture-proven external ventricular drain (EVD)-associated ventriculitis and ten patients without EVD-associated ventriculitis had CSF preserved. Levels of α-defensins were compared between the two cohorts with enzyme-linked immunosorbent assay.
Results:
There was a statistically significant (P ˂0.0001) higher level of CSF α-defensins in the ventriculitis cohort compared to the non-ventriculitis cohort. The levels of α-defensins were not affected by blood in CSF or bacterial virulence. Patients with other infectious conditions had increased levels of α-defensins but these levels were still statistically significantly (P ˂0.001) less than those seen in the ventriculitis cohort.
Conclusion:
This pilot study shows that α-defensins have promise as a biomarker to aid in the diagnosis of ventriculitis. If larger studies support the findings here, this biomarker can help improve diagnostic accuracy and decrease unwarranted empirical broad-spectrum antibiotic use in suspected EVD-associated ventriculitis.
Insights
Alpha-defensins show promise as a diagnostic biomarker for nosocomial ventriculitis. This study found significantly higher alpha-defensin levels in patients with ventriculitis, aiding diagnosis.
Area of Science:
- Neuroscience
- Infectious Diseases
- Biomarker Discovery
Background:
- Nosocomial ventriculitis diagnosis is challenging due to low sensitivity/specificity of standard cerebrospinal fluid (CSF) parameters.
- Current diagnostic methods for meningitis are inadequate for identifying ventriculitis.
- Novel biomarkers are crucial for accurate and timely diagnosis of ventriculitis.
Purpose of the Study:
- To evaluate alpha-defensins (α-defensins) as a potential biomarker for diagnosing ventriculitis.
- To compare α-defensin levels in patients with and without external ventricular drain (EVD)-associated ventriculitis.
Main Methods:
- Pilot study conducted between May 01, 2022, and December 30, 2022.
- Collected CSF samples from ten patients with culture-proven EVD-associated ventriculitis and ten control patients.
- Quantified α-defensin levels using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Significantly elevated CSF α-defensin levels were observed in the ventriculitis cohort (P < 0.0001).
- α-defensin levels were not influenced by the presence of blood in CSF or bacterial virulence.
- While other infections showed increased α-defensins, levels remained significantly lower than in ventriculitis patients (P < 0.001).
Conclusions:
- CSF α-defensins demonstrate potential as a diagnostic biomarker for ventriculitis.
- Further research is needed to validate these findings in larger studies.
- Successful validation could improve diagnostic accuracy and reduce unnecessary antibiotic use.
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