Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/160877 |
Resumo: | The cytological and biochemical examination of cerebrospinal fluid (CSF) has been used for the presumed diagnosis of bacterial meningitis until the final microbiological results are achieved. We assessed the ability of CSF lactate in comparison with other CSF parameters to discriminate bacterial and enteroviral community acquired meningitis. We included 1,187 CSF samples of acute community-acquired meningitis, being 662 cases of bacterial and 525 of enteroviral meningitis. Lactate concentration (mg/dL), leukocyte count/mm3 , protein (mg/dL), and glucose (mg/dL) were compared between bacterial and viral meningitis. Receiver operator characteristic (ROC) curves were used to assess diagnostic performance. CSF leukocytes, CSF protein and CSF lactate were significantly higher in bacterial meningitis cases (P<0.0001). CSF glucose was significantly lower in bacterial meningitis cases (P<0.0001). CSF lactate showed the best predictive ability with an area under the curve of 0.944 (95% CI 0.929 – 0.959). Considering a cut off of CSF lactate of 30 mg/dL, the sensitivity and specificity for bacterial meningitis were 84.1% and 99%, respectively. In the cytological and biochemical CSF analysis, CSF lactate was the most accurate marker for bacterial meningitis. |
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Performance of lactate in discriminating bacterial meningitis from enteroviral meningitisMeningitisBacterial meningitisCerebrospinal fluidLactateThe cytological and biochemical examination of cerebrospinal fluid (CSF) has been used for the presumed diagnosis of bacterial meningitis until the final microbiological results are achieved. We assessed the ability of CSF lactate in comparison with other CSF parameters to discriminate bacterial and enteroviral community acquired meningitis. We included 1,187 CSF samples of acute community-acquired meningitis, being 662 cases of bacterial and 525 of enteroviral meningitis. Lactate concentration (mg/dL), leukocyte count/mm3 , protein (mg/dL), and glucose (mg/dL) were compared between bacterial and viral meningitis. Receiver operator characteristic (ROC) curves were used to assess diagnostic performance. CSF leukocytes, CSF protein and CSF lactate were significantly higher in bacterial meningitis cases (P<0.0001). CSF glucose was significantly lower in bacterial meningitis cases (P<0.0001). CSF lactate showed the best predictive ability with an area under the curve of 0.944 (95% CI 0.929 – 0.959). Considering a cut off of CSF lactate of 30 mg/dL, the sensitivity and specificity for bacterial meningitis were 84.1% and 99%, respectively. In the cytological and biochemical CSF analysis, CSF lactate was the most accurate marker for bacterial meningitis.Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2019-08-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/xmlhttps://www.revistas.usp.br/rimtsp/article/view/16087710.1590/s1678-9946201961024Revista do Instituto de Medicina Tropical de São Paulo; Vol. 61 (2019); e24Revista do Instituto de Medicina Tropical de São Paulo; Vol. 61 (2019); e24Revista do Instituto de Medicina Tropical de São Paulo; v. 61 (2019); e241678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/160877/155031https://www.revistas.usp.br/rimtsp/article/view/160877/155492Copyright (c) 2019 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessDomingues, Renan BarrosFernandes, Gustavo Bruniera PeresLeite, Fernando Brunale Vilela de MouraSenne, Carlos2019-08-09T14:05:02Zoai:revistas.usp.br:article/160877Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:52:48.841972Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis |
title |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis |
spellingShingle |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis Domingues, Renan Barros Meningitis Bacterial meningitis Cerebrospinal fluid Lactate |
title_short |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis |
title_full |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis |
title_fullStr |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis |
title_full_unstemmed |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis |
title_sort |
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis |
author |
Domingues, Renan Barros |
author_facet |
Domingues, Renan Barros Fernandes, Gustavo Bruniera Peres Leite, Fernando Brunale Vilela de Moura Senne, Carlos |
author_role |
author |
author2 |
Fernandes, Gustavo Bruniera Peres Leite, Fernando Brunale Vilela de Moura Senne, Carlos |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Domingues, Renan Barros Fernandes, Gustavo Bruniera Peres Leite, Fernando Brunale Vilela de Moura Senne, Carlos |
dc.subject.por.fl_str_mv |
Meningitis Bacterial meningitis Cerebrospinal fluid Lactate |
topic |
Meningitis Bacterial meningitis Cerebrospinal fluid Lactate |
description |
The cytological and biochemical examination of cerebrospinal fluid (CSF) has been used for the presumed diagnosis of bacterial meningitis until the final microbiological results are achieved. We assessed the ability of CSF lactate in comparison with other CSF parameters to discriminate bacterial and enteroviral community acquired meningitis. We included 1,187 CSF samples of acute community-acquired meningitis, being 662 cases of bacterial and 525 of enteroviral meningitis. Lactate concentration (mg/dL), leukocyte count/mm3 , protein (mg/dL), and glucose (mg/dL) were compared between bacterial and viral meningitis. Receiver operator characteristic (ROC) curves were used to assess diagnostic performance. CSF leukocytes, CSF protein and CSF lactate were significantly higher in bacterial meningitis cases (P<0.0001). CSF glucose was significantly lower in bacterial meningitis cases (P<0.0001). CSF lactate showed the best predictive ability with an area under the curve of 0.944 (95% CI 0.929 – 0.959). Considering a cut off of CSF lactate of 30 mg/dL, the sensitivity and specificity for bacterial meningitis were 84.1% and 99%, respectively. In the cytological and biochemical CSF analysis, CSF lactate was the most accurate marker for bacterial meningitis. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-08-09 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/160877 10.1590/s1678-9946201961024 |
url |
https://www.revistas.usp.br/rimtsp/article/view/160877 |
identifier_str_mv |
10.1590/s1678-9946201961024 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/160877/155031 https://www.revistas.usp.br/rimtsp/article/view/160877/155492 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Revista do Instituto de Medicina Tropical de São Paulo info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 Revista do Instituto de Medicina Tropical de São Paulo |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 61 (2019); e24 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 61 (2019); e24 Revista do Instituto de Medicina Tropical de São Paulo; v. 61 (2019); e24 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
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1798951652260052992 |