Comparison of cerebrospinal fluid lactate with physical, cytological, and other biochemical characteristics as prognostic factors in acute bacterial meningitis

Abstract

Bacterial meningitis (BM) is associated with a high morbidity and mortality. Cerebrospinal fluid (CSF) lactate may be used as a prognostic marker of this condition. We hypothesized that CSF lactate levels would remain elevated in participants who died of acute BM compared with those who recovered from this disease. Objective: To evaluate the potential use of lactate and other CSF biomarkers as prognostic markers of acute BM outcome. Methods: This retrospective, longitudinal study evaluated dynamic CSF biomarkers in 223 CSF samples from 49 patients who fulfilled the inclusion criteria of acute BM, with bacteria identified by CSF culturing. The participants were grouped according to outcome: death (n = 9; 18.37%) and survival (n = 40; 81.63%). All participants received appropriate antibiotic treatment. Results: In the logistic regression model, lactate concentration in the final CSF sample, xanthochromia, and CSF glucose variation between the first and last CSF samples were predictors of a poor outcome (death). In contrast, decrease in CSF white blood cell count and CSF percentage of neutrophils, increase in the percentage of lymphocytes, and normalization of the CSF lactate concentration in the last CSF sample were predictors of a good prognosis. Conclusion: The study confirmed the initial hypothesis. The longitudinal analysis of CSF lactate is an important predictor of prognosis in acute BM.

Laboratory-Based Cytological and Biochemical Profile of Cerebrospinal Fluid for Children With Acute Bacterial Meningitis in Bangladesh

“…1). The WBC ≥ 100/ mm 3 of the CSF is a more noteworthy rate were affirmed as bacterial meningitis individuals, which is steady with the standard portrayal of speculated bacterial contamination and, along these lines, a helpful trademark to survey the nearness of bacterial meningitis where culture offices are not accessible (Almeida et al 2019).…”

The Diagnostic Value of Cerebrospinal Fluid Lactate for Detection of Sepsis in Community-Acquired Bacterial Meningitis

“…Following this argumentation, CSF lactate is expected to increase with severity of infection, explaining the association with sepsis in bacterial meningitis in our study. Accordingly, CSF lactate has been shown previously to correlate with poorer outcome both in animal models and retrospective patient cohorts, which was also shown in our cohort [ 35 , 36 , 37 ]. In addition to being a mere marker of disease severity, elevated CSF lactate might also directly contribute to it, as N. meningitidis and S. pneumoniae can use lactate as a carbon source in absence of glucose, thus sustaining bacterial growth as CSF glucose levels fall rapidly [ 32 ].…”

D-Dimer as Biomarker for Early Prediction of Clinical Outcomes in Patients With Severe Invasive Infections Due to Streptococcus Pneumoniae and Neisseria Meningitidis

“…Finally, several studies have evaluated the role of prognostic biomarkers in case of bacterial meningitis: matrix metalloproteinases-8 assessed on CSF has been presented as an attractive prognostic biomarker in children (24), and longitudinal analysis of CSF lactate resulted to be an important predictor of prognosis (25). However, the advantage of measuring a biomarker directly from venous blood, in an easy and inexpensive way, with results rapidly available and everywhere, is evident.…”