Diagnostic value of cerebrospinal fluid levels of D-lactate, tumour necrosis factor-alpha and interleukin-6,-8, and-17 in suspected nosocomial meningitis

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Goktas S. Y., Oral A., Yılmaz E., Akalın E. H., Guvenc F., Ozkaya G., ...More

SINGAPORE MEDICAL JOURNAL, vol.65, no.8, pp.430-437, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 65 Issue: 8
  • Publication Date: 2024
  • Doi Number: 10.11622/smedj.2021123
  • Journal Name: SINGAPORE MEDICAL JOURNAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, CINAHL, Veterinary Science Database
  • Page Numbers: pp.430-437
  • Keywords: Cytokine, D-lactate, IL-17, IL-6, IL-8, nosocomial meningitis, TNF-α
  • Bursa Uludag University Affiliated: Yes

Abstract

Introduction: This study aimed to determine the diagnostic value of interleukin (IL)-6, IL-8, IL-17, tumour necrosis factor-alpha (TNF-alpha) and D-lactate levels in the cerebrospinal fluid (CSF) of nosocomial meningitis patients. Methods: The CSF levels of cytokines and D-lactate were compared across 29 episodes of nosocomial meningitis, 38 episodes of pleocytosis (without meningitis) and 54 control subjects. Results: The CSF levels of IL-6, IL-8, and D-lactate were higher in the group with nosocomial meningitis compared to the control group and the group with pleocytosis without meningitis (P < 0.05). For IL-6 levels (threshold: >440 pg/mL), the sensitivity and specificity were 55.17% and 94.74%, respectively. For IL-8 levels (threshold: >1,249 pg/mL), the sensitivity and specificity were 44.83% and 84.21%, respectively. In patients with nosocomial meningitis, when the threshold of D-lactate levels was >1.05 mu mol/mL, the sensitivity and specificity were 75.86% and 63.16%, respectively. In pleocytosis (without meningitis) CSF samples and in nosocomial meningitis CSF samples, the highest area under the receiver operating characteristic curve (AUC) was calculated for triple combination model of IL-6, IL-8 and D-lactate levels (AUC 0.801, P < 0.001) and double combination model of IL-6 and IL-8 (AUC 0.790, P < 0.001). Conclusion: Our study findings suggest that IL-6, IL-8 and D-lactate levels could be diagnostic markers for nosocomial meningitis.