Evaluating the diagnostic significance of biomarkers in ventriculitis through a multivariate correlation study in a...

Ventriculitis poses a critical risk in neurocritical care, requiring swift diagnosis for timely treatment. This study assessed the diagnostic value of cerebrospinal fluid biomarkers (IL-6, IL-10, TNF-α, procalcitonin (PCT), C-reactive protein (CRP), and CSF lactate) in conjunction with CSF microbial profiling and antimicrobial susceptibility in patients with ventriculitis. This prospective observational study was conducted from July 2023 to May 2024 at the Neuromicrobiology Department, National Institute of Mental Health and Neuroscience (NIMHANS) and analyzed cerebrospinal fluid from patients undergoing routine microbiological culture and sensitivity tests. The study involved 159 patients divided into control, probable, and confirmed ventriculitis groups. Standard methods were used for microbial isolation and antimicrobial susceptibility testing. Additionally, CSF biomarker levels were measured to provide deeper insights into patient conditions. Our study revealed elevated IL-6, IL-10, TNF-α, procalcitonin (PCT), C-reactive protein (CRP), and CSF lactate, levels in both confirmed and probable ventriculitis patients, with IL-6 being the most accurate diagnostic biomarker. Cerebral neoplasm was the most prevalent condition (44·1%), with headache as the primary symptom. Acinetobacter baumannii (39·4%), Escherichia coli (18·2%), and Klebsiella pneumoniae (15·2%) were the most common pathogens identified in CSF cultures. Acinetobacter baumannii and Klebsiella pneumoniae were identified as highly susceptible to colistin but showed significant resistance to carbapenems and variable resistance to other antibiotics. This study emphasizes the severe impact of ventriculitis and identifies IL-6, IL-10, and TNF-alpha as effective biomarkers for diagnosing ventriculitis, with high sensitivity, specificity, and diagnostic performance. Significant antibiotic resistance highlights the need for effective infection control.