Serum procalcitonin and other biologic markers to distinguish between bacterial and aseptic meningitis
To identify the biologic tests that best distinguish between bacterial and aseptic meningitis in an emergency department (ED). All children hospitalized for bacterial meningitis between 1995 and 2004 or for aseptic meningitis between 2000 and 2004 were included in a retrospective cohort study. Predi...
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| Veröffentlicht in: | The Journal of pediatrics 2006-07, Vol.149 (1), p.72-76 |
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| container_title | The Journal of pediatrics |
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| creator | Dubos, Francois Moulin, Florence Gajdos, Vincent De Suremain, Nathalie Biscardi, Sandra Lebon, Pierre Raymond, Josette Breart, Gerard Gendrel, Dominique Chalumeau, Martin |
| description | To identify the biologic tests that best distinguish between bacterial and aseptic meningitis in an emergency department (ED).
All children hospitalized for bacterial meningitis between 1995 and 2004 or for aseptic meningitis between 2000 and 2004 were included in a retrospective cohort study. Predictive values of blood (C-reactive protein, procalcitonin [PCT], white blood cell [WBC] count, neutrophil count) and cerebrospinal fluid (CSF) findings (protein, glucose, WBC count, neutrophil count) available in the ED were determined. Tests with the best predictive value were identified by using univariate and multivariate analyses and ROC curves comparison.
Among the 167 patients included, 21 had bacterial meningitis. The CSF gram-stain and bacterial antigen test had 86% and 60% sensitivity rates, respectively. PCT (≥0.5 ng/mL) and CSF protein (≥0.5 g/L) were the best biologic tests, with 89% and 86% sensitivity rates, 89% and 78% specificity rates, adjusted odds ratios of 108 (95% CI, 15-772) and 34 (95% CI, 5-217), and areas under the ROC curves of 0.95 and 0.93, respectively.
PCT and CSF protein had the best predictive value to distinguish between bacterial and aseptic meningitis in children. |
| doi_str_mv | 10.1016/j.jpeds.2006.02.034 |
| format | Article |
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All children hospitalized for bacterial meningitis between 1995 and 2004 or for aseptic meningitis between 2000 and 2004 were included in a retrospective cohort study. Predictive values of blood (C-reactive protein, procalcitonin [PCT], white blood cell [WBC] count, neutrophil count) and cerebrospinal fluid (CSF) findings (protein, glucose, WBC count, neutrophil count) available in the ED were determined. Tests with the best predictive value were identified by using univariate and multivariate analyses and ROC curves comparison.
Among the 167 patients included, 21 had bacterial meningitis. The CSF gram-stain and bacterial antigen test had 86% and 60% sensitivity rates, respectively. PCT (≥0.5 ng/mL) and CSF protein (≥0.5 g/L) were the best biologic tests, with 89% and 86% sensitivity rates, 89% and 78% specificity rates, adjusted odds ratios of 108 (95% CI, 15-772) and 34 (95% CI, 5-217), and areas under the ROC curves of 0.95 and 0.93, respectively.
PCT and CSF protein had the best predictive value to distinguish between bacterial and aseptic meningitis in children.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2006.02.034</identifier><identifier>PMID: 16860131</identifier><identifier>CODEN: JOPDAB</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Bacterial diseases ; Bacterial diseases of the nervous system. Bacterial myositis ; Biological and medical sciences ; Biomarkers - blood ; Biomarkers - cerebrospinal fluid ; C-Reactive Protein - analysis ; Calcitonin - blood ; Calcitonin Gene-Related Peptide ; Cerebrospinal Fluid Proteins - analysis ; Child ; Child, Preschool ; Cohort Studies ; Diagnosis, Differential ; Female ; General aspects ; Glucose - cerebrospinal fluid ; Human bacterial diseases ; Humans ; Infant ; Infectious diseases ; Leukocyte Count ; Male ; Medical sciences ; Meningitis, Aseptic - blood ; Meningitis, Aseptic - cerebrospinal fluid ; Meningitis, Aseptic - diagnosis ; Meningitis, Bacterial - blood ; Meningitis, Bacterial - cerebrospinal fluid ; Meningitis, Bacterial - diagnosis ; Neutrophils - metabolism ; Protein Precursors - blood ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity</subject><ispartof>The Journal of pediatrics, 2006-07, Vol.149 (1), p.72-76</ispartof><rights>2006 Elsevier Inc.</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-ff523d936e56c877883c584bbcbf0b24e5b7ab5d32a1ebbf2c34e8090df8da803</citedby><cites>FETCH-LOGICAL-c453t-ff523d936e56c877883c584bbcbf0b24e5b7ab5d32a1ebbf2c34e8090df8da803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2006.02.034$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18005030$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16860131$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dubos, Francois</creatorcontrib><creatorcontrib>Moulin, Florence</creatorcontrib><creatorcontrib>Gajdos, Vincent</creatorcontrib><creatorcontrib>De Suremain, Nathalie</creatorcontrib><creatorcontrib>Biscardi, Sandra</creatorcontrib><creatorcontrib>Lebon, Pierre</creatorcontrib><creatorcontrib>Raymond, Josette</creatorcontrib><creatorcontrib>Breart, Gerard</creatorcontrib><creatorcontrib>Gendrel, Dominique</creatorcontrib><creatorcontrib>Chalumeau, Martin</creatorcontrib><title>Serum procalcitonin and other biologic markers to distinguish between bacterial and aseptic meningitis</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To identify the biologic tests that best distinguish between bacterial and aseptic meningitis in an emergency department (ED).
All children hospitalized for bacterial meningitis between 1995 and 2004 or for aseptic meningitis between 2000 and 2004 were included in a retrospective cohort study. Predictive values of blood (C-reactive protein, procalcitonin [PCT], white blood cell [WBC] count, neutrophil count) and cerebrospinal fluid (CSF) findings (protein, glucose, WBC count, neutrophil count) available in the ED were determined. Tests with the best predictive value were identified by using univariate and multivariate analyses and ROC curves comparison.
Among the 167 patients included, 21 had bacterial meningitis. The CSF gram-stain and bacterial antigen test had 86% and 60% sensitivity rates, respectively. PCT (≥0.5 ng/mL) and CSF protein (≥0.5 g/L) were the best biologic tests, with 89% and 86% sensitivity rates, 89% and 78% specificity rates, adjusted odds ratios of 108 (95% CI, 15-772) and 34 (95% CI, 5-217), and areas under the ROC curves of 0.95 and 0.93, respectively.
PCT and CSF protein had the best predictive value to distinguish between bacterial and aseptic meningitis in children.</description><subject>Adolescent</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the nervous system. Bacterial myositis</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Biomarkers - cerebrospinal fluid</subject><subject>C-Reactive Protein - analysis</subject><subject>Calcitonin - blood</subject><subject>Calcitonin Gene-Related Peptide</subject><subject>Cerebrospinal Fluid Proteins - analysis</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>General aspects</subject><subject>Glucose - cerebrospinal fluid</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Leukocyte Count</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Meningitis, Aseptic - blood</subject><subject>Meningitis, Aseptic - cerebrospinal fluid</subject><subject>Meningitis, Aseptic - diagnosis</subject><subject>Meningitis, Bacterial - blood</subject><subject>Meningitis, Bacterial - cerebrospinal fluid</subject><subject>Meningitis, Bacterial - diagnosis</subject><subject>Neutrophils - metabolism</subject><subject>Protein Precursors - blood</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kDuPEzEUhS0EYsPCL0BCbqCb4doee5yCAq14SStRALXlx52sw2QcbA-If4-zibQd1W2-c3TPR8hLBj0Dpt7u-_0RQ-k5gOqB9yCGR2TDYDt2SgvxmGwAOO_EMKor8qyUPQBsB4Cn5IoprYAJtiHTN8zrgR5z8nb2saYlLtQugaZ6h5m6mOa0i54ebP6JudCaaIilxmW3xnJHHdY_iAt11lfM0c73WVvwWE8hbG27WGN5Tp5Mdi744nKvyY-PH77ffO5uv376cvP-tvODFLWbJslF2AqFUnk9jloLL_XgnHcTOD6gdKN1MghuGTo3cS8G1LCFMOlgNYhr8ubc2wb9WrFUc4jF4zzbBdNaTNutJJdjA8UZ9DmVknEyxxzbyL-GgTnpNXtzr9ec9BrgpultqVeX-tUdMDxkLj4b8PoC2NKETtkuPpYHTgNIEKc_3505bDJ-R8ym-IiLxxAz-mpCiv995B9RPpwC</recordid><startdate>20060701</startdate><enddate>20060701</enddate><creator>Dubos, Francois</creator><creator>Moulin, Florence</creator><creator>Gajdos, Vincent</creator><creator>De Suremain, Nathalie</creator><creator>Biscardi, Sandra</creator><creator>Lebon, Pierre</creator><creator>Raymond, Josette</creator><creator>Breart, Gerard</creator><creator>Gendrel, Dominique</creator><creator>Chalumeau, Martin</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20060701</creationdate><title>Serum procalcitonin and other biologic markers to distinguish between bacterial and aseptic meningitis</title><author>Dubos, Francois ; Moulin, Florence ; Gajdos, Vincent ; De Suremain, Nathalie ; Biscardi, Sandra ; Lebon, Pierre ; Raymond, Josette ; Breart, Gerard ; Gendrel, Dominique ; Chalumeau, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c453t-ff523d936e56c877883c584bbcbf0b24e5b7ab5d32a1ebbf2c34e8090df8da803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the nervous system. Bacterial myositis</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Biomarkers - cerebrospinal fluid</topic><topic>C-Reactive Protein - analysis</topic><topic>Calcitonin - blood</topic><topic>Calcitonin Gene-Related Peptide</topic><topic>Cerebrospinal Fluid Proteins - analysis</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>General aspects</topic><topic>Glucose - cerebrospinal fluid</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Leukocyte Count</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Meningitis, Aseptic - blood</topic><topic>Meningitis, Aseptic - cerebrospinal fluid</topic><topic>Meningitis, Aseptic - diagnosis</topic><topic>Meningitis, Bacterial - blood</topic><topic>Meningitis, Bacterial - cerebrospinal fluid</topic><topic>Meningitis, Bacterial - diagnosis</topic><topic>Neutrophils - metabolism</topic><topic>Protein Precursors - blood</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dubos, Francois</creatorcontrib><creatorcontrib>Moulin, Florence</creatorcontrib><creatorcontrib>Gajdos, Vincent</creatorcontrib><creatorcontrib>De Suremain, Nathalie</creatorcontrib><creatorcontrib>Biscardi, Sandra</creatorcontrib><creatorcontrib>Lebon, Pierre</creatorcontrib><creatorcontrib>Raymond, Josette</creatorcontrib><creatorcontrib>Breart, Gerard</creatorcontrib><creatorcontrib>Gendrel, Dominique</creatorcontrib><creatorcontrib>Chalumeau, Martin</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dubos, Francois</au><au>Moulin, Florence</au><au>Gajdos, Vincent</au><au>De Suremain, Nathalie</au><au>Biscardi, Sandra</au><au>Lebon, Pierre</au><au>Raymond, Josette</au><au>Breart, Gerard</au><au>Gendrel, Dominique</au><au>Chalumeau, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum procalcitonin and other biologic markers to distinguish between bacterial and aseptic meningitis</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2006-07-01</date><risdate>2006</risdate><volume>149</volume><issue>1</issue><spage>72</spage><epage>76</epage><pages>72-76</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><coden>JOPDAB</coden><abstract>To identify the biologic tests that best distinguish between bacterial and aseptic meningitis in an emergency department (ED).
All children hospitalized for bacterial meningitis between 1995 and 2004 or for aseptic meningitis between 2000 and 2004 were included in a retrospective cohort study. Predictive values of blood (C-reactive protein, procalcitonin [PCT], white blood cell [WBC] count, neutrophil count) and cerebrospinal fluid (CSF) findings (protein, glucose, WBC count, neutrophil count) available in the ED were determined. Tests with the best predictive value were identified by using univariate and multivariate analyses and ROC curves comparison.
Among the 167 patients included, 21 had bacterial meningitis. The CSF gram-stain and bacterial antigen test had 86% and 60% sensitivity rates, respectively. PCT (≥0.5 ng/mL) and CSF protein (≥0.5 g/L) were the best biologic tests, with 89% and 86% sensitivity rates, 89% and 78% specificity rates, adjusted odds ratios of 108 (95% CI, 15-772) and 34 (95% CI, 5-217), and areas under the ROC curves of 0.95 and 0.93, respectively.
PCT and CSF protein had the best predictive value to distinguish between bacterial and aseptic meningitis in children.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>16860131</pmid><doi>10.1016/j.jpeds.2006.02.034</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Bacterial diseases Bacterial diseases of the nervous system. Bacterial myositis Biological and medical sciences Biomarkers - blood Biomarkers - cerebrospinal fluid C-Reactive Protein - analysis Calcitonin - blood Calcitonin Gene-Related Peptide Cerebrospinal Fluid Proteins - analysis Child Child, Preschool Cohort Studies Diagnosis, Differential Female General aspects Glucose - cerebrospinal fluid Human bacterial diseases Humans Infant Infectious diseases Leukocyte Count Male Medical sciences Meningitis, Aseptic - blood Meningitis, Aseptic - cerebrospinal fluid Meningitis, Aseptic - diagnosis Meningitis, Bacterial - blood Meningitis, Bacterial - cerebrospinal fluid Meningitis, Bacterial - diagnosis Neutrophils - metabolism Protein Precursors - blood Retrospective Studies ROC Curve Sensitivity and Specificity |
| title | Serum procalcitonin and other biologic markers to distinguish between bacterial and aseptic meningitis |
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