Liu Yong-Juan, Shao Li-Hua, Zhang Jian, Fu Shan-Ji, Wang Gang, Chen Feng-Zhe, Zheng Feng, Ma Rui-Ping, Liu Hai-Hong, Dong Xiao-Meng, Ma Li-Xian
Ann Clin Microbiol Antimicrob. 2015 Mar 23;14:17. doi: 10.1186/s12941-015-0078-0.
Early diagnosis and appropriate antibiotic treatment can significantly reduce mortality of nosocomial bacterial meningitis. However, it is a challenge for clinicians to make an accurate and rapid diagnosis of bacterial meningitis. This study aimed at determining whether combined biomarkers can provide a useful tool for the diagnosis of bacterial meningitis.
A retrospective study was carried out. Cerebrospinal fluid (CSF) levels of decoy receptor 3 (DcR3) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) were detected by enzyme-linked immunosorbent assay (ELISA).
The patients with bacterial meningitis had significantly elevated levels of the above mentioned biomarkers. The two biomarkers were all risk factors with bacterial meningitis. The biomarkers were constructed into a "bioscore". The discriminative performance of the bioscore was better than that of each biomarker, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.842 (95% confidence intervals (CI) 0.770-0.914; p< 0.001).
Combined measurement of CSF DcR3 and sTREM-1 concentrations improved the prediction of nosocomial bacterial meningitis. The combined strategy is of interest and the validation of that improvement needs further studies.
早期诊断和恰当的抗生素治疗可显著降低医院获得性细菌性脑膜炎的死亡率。然而,对临床医生而言,准确快速地诊断细菌性脑膜炎是一项挑战。本研究旨在确定联合生物标志物是否可为细菌性脑膜炎的诊断提供有用工具。
开展一项回顾性研究。采用酶联免疫吸附测定(ELISA)检测脑脊液(CSF)中诱饵受体3(DcR3)和髓系细胞触发受体-1(sTREM-1)的水平。
细菌性脑膜炎患者上述生物标志物水平显著升高。这两种生物标志物均为细菌性脑膜炎的危险因素。将这些生物标志物构建成一个“生物评分”。该生物评分的鉴别性能优于每种生物标志物,其受试者工作特征(ROC)曲线下面积(AUC)为0.842(95%置信区间(CI)0.770 - 0.914;p < 0.001)。
联合检测脑脊液DcR3和sTREM-1浓度可改善对医院获得性细菌性脑膜炎的预测。这种联合策略值得关注,其有效性还需进一步研究验证。