Infection and Drug Resistance (Jul 2021)
Evaluation of the Diagnostic and Prognostic Value of CSF Presepsin Levels in Patients with Postneurosurgical Ventriculitis/Meningitis
Abstract
Guanghui Zheng,1– 3,* Chenxi Zhang,1– 3,* Guojun Zhang,1– 3 Chunqing Shao1– 3 1Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital and Capital Medical University, Beijing, People’s Republic of China; 2NMPA Key Laboratory for Quality Control of in vitro Diagnostics, National Medical Products Administration, Beijing, People’s Republic of China; 3Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing Municipal Science and Technology Commission, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunqing Shao; Guojun Zhang Tel +86 18600148997; +86 15811219411Email [email protected]; [email protected]: To evaluate the diagnostic and prognostic value of CSF presepsin levels in patients with postneurosurgical ventriculitis/meningitis (PNVM).Methods: We conducted a case-control study to achieve our aims. First, we prospectively enrolled patients who had undergone neurosurgery in Beijing Tiantan Hospital from June to November 2020 and measured the CSF levels of 8 biomarkers, including presepsin and other meningitis biomarkers. The diagnostic and prognostic accuracies of presepsin levels were evaluated by determining the values for the area under the receiver operating characteristic curve (AUC).Results: Two hundred thirty-nine patients were enrolled in this study; 34 were diagnosed with confirmed ventriculitis/meningitis (cVM), 138 were classified as probable ventriculitis/meningitis (pVM), and the others were rejected ventriculitis/meningitis (rVM). Presepsin levels effectively diagnose cVM and predict the outcomes of patients with PNVM, with thresholds of 1257.4 pg/mL and 1276.2 pg/mL and AUCs of 0.746 and 0.825, respectively. Furthermore, a joint analysis with CSF lactate (C-Lac) levels shows that the AUCs of the two markers increased to 0.856 and 0.872, respectively.Conclusion: The rapid diagnosis and prediction of the clinical outcome is important in neurosurgery. CSF presepsin levels are an impressive diagnostic and prognostic biomarker for meningitis, and when combined with C-Lac, they indeed improve the diagnostic and predictive efficiency of PNVM.Keywords: presepsin, cerebrospinal fluid, postneurosurgical ventriculitis/meningitis
