El-Kady Huda, Mostafa Mona Gamal, Madkour Shaimaa
Department of Pediatrics, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Department of Clinical and Chemical Pathology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
BMC Pediatr. 2025 Jan 6;25(1):7. doi: 10.1186/s12887-024-05315-8.
Pediatric CNS infections have been identified as a global health problem, associated with an increased death rate and fatal consequences. Pentraxin 3 (PTX3) is an acute-phase mediator that increases in body fluids and plasma throughout inflammation. Our study was designed to assess the diagnostic and prognostic value of cerebrospinal fluid (CSF) PTX3 levels in pediatric patients with different central nervous system (CNS) infections.
We enrolled 100 children hospitalized at Fayoum University Children's Hospital with suspected CNS infections fulfilling the case criteria for CNS infections. We recorded their medical history and examination data upon admission. The C-reactive protein (CRP) level, complete blood count (CBC), CSF PTX3 level, CSF analysis and culture, and blood culture were assessed in all patients at the time of admission.
Levels of PTX3 were significantly correlated with the duration of symptoms before admission, length of hospital stay, patient outcomes, CRP levels, CSF findings, and CSF cultures (P value < 0.001). Patients who needed mechanical ventilation or experienced adverse outcomes had greater levels of PTX3, which were more prevalent in those with a bacterial etiology (P value < 0.05).
PTX3 indicates disease severity and prognosis. PTX3 showed statistically significant sensitivity when discriminating between bacterial and aseptic CNS infections, as well as between bacterial CNS infections and controls. However, it has lower sensitivity and specificity than other CSF biomarkers, though it is higher than serum CRP.
小儿中枢神经系统感染已被确定为一个全球性的健康问题，与死亡率上升和致命后果相关。五聚体3（PTX3）是一种急性期介质，在整个炎症过程中其在体液和血浆中的水平会升高。我们的研究旨在评估脑脊液（CSF）PTX3水平在不同中枢神经系统（CNS）感染的小儿患者中的诊断和预后价值。
我们纳入了法尤姆大学儿童医院收治的100例疑似CNS感染且符合CNS感染病例标准的儿童。我们记录了他们入院时的病史和检查数据。在所有患者入院时评估其C反应蛋白（CRP）水平、全血细胞计数（CBC）、脑脊液PTX3水平、脑脊液分析和培养以及血培养。
PTX3水平与入院前症状持续时间、住院时间、患者预后、CRP水平、脑脊液检查结果和脑脊液培养显著相关（P值<0.001）。需要机械通气或经历不良预后的患者PTX3水平更高，在细菌病因的患者中更常见（P值<0.05）。
PTX3可指示疾病的严重程度和预后。在区分细菌性和无菌性CNS感染以及细菌性CNS感染与对照时，PTX3显示出具有统计学意义的敏感性。然而，尽管它高于血清CRP，但与其他脑脊液生物标志物相比，其敏感性和特异性较低。
