Glucose consumption by polymorphonuclear leukocytes in the cerebrospinal fluid of patients with bacterial meningitis

Bretz, Gedeon W.; Mauer, Alvin M.

doi:10.1016/s0022-3476(67)80328-7

Cited by 6 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Taking into account early work on animal experimental meningitis, it is conceivable that a synergy between CSF inflammatory mechanisms and the presence of glucophagic microorganisms stimulates leukocytic glucose catabolism. 17 , 19 Alternatively, glucose transport across the blood-brain barrier might be reduced as proposed in cases of tuberculous meningitis 2 and experimental meningitis. 16…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pleocytosis is not fully responsible for low CSF glucose in meningitis

Baud

Vitt

Robbins

et al. 2018

Neurol Neuroimmunol Neuroinflamm

View full text Add to dashboard Cite

Objective:The mechanism of hypoglycorrhachia—low CSF glucose—in meningitis remains unknown. We sought to evaluate the relative contribution of CSF inflammation vs microorganisms (bacteria and fungi) in lowering CSF glucose levels.Methods:We retrospectively categorized CSF profiles into microbial and aseptic meningitis and analyzed CSF leukocyte count, glucose, and protein concentrations. We assessed the relationship between these markers using multivariate and stratified linear regression analysis for initial and repeated CSF sampling. We also calculated the receiver operating characteristics of CSF glucose and CSF-to-serum glucose ratios to presumptively diagnose microbial meningitis.Results:We found that increasing levels of CSF inflammation were associated with decreased CSF glucose levels in the microbial but not aseptic category. Moreover, elevated CSF protein levels correlated more strongly than the leukocyte count with low CSF glucose levels on initial (R2 = 36%, p < 0.001) and repeated CSF sampling (R2 = 46%, p < 0.001). Hypoglycorrhachia (<40 mg/dL) was observed in 50.1% of microbial cases, but only 9.6% of aseptic cases, most of which were neurosarcoidosis. Absolute CSF glucose and CSF-to-serum glucose ratios had similar low sensitivity and moderate-to-high specificity in diagnosing microbial meningitis at thresholds commonly used.Conclusions:The main driver of hypoglycorrhachia appears to be a combination of microbial meningitis with moderate to high degrees of CSF inflammation and proteins, suggesting that the presence of microorganisms capable of catabolizing glucose is a determinant of hypoglycorrhachia in meningitis. A major notable exception is neurosarcoidosis. Low CSF glucose and CSF-to-serum glucose ratios are useful markers for the diagnosis of microbial meningitis.

show abstract

Section: Discussionmentioning

confidence: 99%

“… 17 Finally, the uptake of radiolabeled glucose was increased in neutrophils derived from purulent CSF, showing that they contribute to glucose depletion. 19 To our knowledge, these experimental results have never been correlated with large human clinical data sets, despite recent advances in the understanding of immune mechanisms at play in meningitis.…”

mentioning

confidence: 99%

Pleocytosis is not fully responsible for low CSF glucose in meningitis

Baud

Vitt

Robbins

et al. 2018

Neurol Neuroimmunol Neuroinflamm

View full text Add to dashboard Cite

show abstract

“…7 Both activated leukocytes and bacteria are required to lower CSF glucose concentration. [8][9][10] Altered glucose transport across inflamed membranes has also been a proposed mechanism for hypoglycorrhachia in bacterial meningitis. 16 This understanding makes it plausible that the presence of bacteria andactivated leukocytes in amniotic fluid may result in decreased concentrations of glucose.…”

Section: Discussionmentioning

confidence: 99%

Amniotic Fluid Glucose Concentration: A Marker for Infection in Preterm Labor and Preterm Premature Rupture of Membranes

Dildy

Pearlman

Smith

et al. 1993

Infectious Diseases in Obstetrics and Gynecology

View full text Add to dashboard Cite

Amniotic fluid Gram stain and culture have been utilized as laboratory tests of microbial invasion of the amniotic cavity. The Gram stain of amniotic fluid has a low sensitivity in the detection of clinical infection or microbial invasion of the amniotic cavity, and amniotic fluid culture results are not immediately available for management decisions. Glucose concentration is used to diagnose infection in other sites such as cerebrospinal fluid. Objective: The purpose of this study was to evaluate the usefulness of amniotic fluid glucose concentration in detecting microbial invasion of the amniotic cavity associated with preterm labor and preterm premature rupture of membranes. Methods: Amniocentesis was performed in 60 women with preterm labor and/or preterm premature rupture of membranes. Gram stain and culture for Mycoplasma hominis, Ureaplasma urealyticum, aerobic, and anaerobic bacteria were performed. Subjects were studied prospectively for the development of positive amniotic fluid cultures and the development of clinical chorioamnionitis. Results: The diagnosis of clinical chorioamnionitis was made in 25% (15/60) of women entered into the study. Low amniotic fluid glucose concentration Was considered < 15 mg/dl. The sensitivity, specificity, and positive predictive value of low amniotic, fluid glucose concentration to predict clinical chorioamnionitis were 73.3%, 88.1%, and 68.8% respectively, while positive amniotic fluid culture, hada sensitivity of 43.8%, specificity of 79.5%, and positive predictive value of 43.8%. Conclusions: Amniotic fluid glucose concentration was more sensitive in predicting chorioamnionitis than either Gram stain or culture. Amniotic fluid glucose concentration was better in predicting clinical chorioamnionitis than predicting positive amniotic fluid culture results. Gestational age-dependent normal ranges and pathologic conditions that may alter amniotic fluid glucose concentrations should be considered when interpreting amniotic fluid glucose values to diagnose microbial invasion of the amniotic cavity.

show abstract

“…La disminución en la concentración de glucosa en detenmnado flmdo corporal (por ejemplo, ha si do utilizado como prueba de mfeccwn , con un suficiente valor predictivo . (ll, [13][14][15][16][17]. .…”

Section: Marco Teóricounclassified

Determinación de glucosa en líquido amniótico como valor predictivo de infección intraamniótica en pacientes con trabajo de parto pretérmino

Baquero

Bonivento

Sarmiento

1996

Rev. Colomb. Obstet. Ginecol.

View full text Add to dashboard Cite

OBJETIVO: Determinar la utilidad de la concentración de glucosa en líquido amniótico en pacientes con trabajo de parto pretermino, como factor predictivo de infección intraamniótica.MATERIAL Y METODOS: Se practicó amniocentesis a 56 gestantes con trabajo de parto pretérmino y membranas íntegras, enviándose muestra para Gram, cultivo y concentración de glucosa. Simultáneamente se obtuvieron muestras de líquido amniótico en 62 pacientes a quienes se les indicó amniocentesis por otras patologías y que sirvieron de grupo de control. Se correlacionaron los resultados con la presencia de parto pretérmino y/o evidencia clínica de corioamnionitis utilizando métodos estadísticos de Chi cuadrado y "t" test.RESULTADOS: La incidencia de infección intraamniótica detenninada como cultivo positivo en pacientes con trabajo de parto pretérmino, fue del 17% (10/56). Un 14% de pacientes en el grupo problema (8/56) cumplieron criterios clínicos para corioamnionitis. El valor medio de glucosa en pacientes del grupo de control fue de 31.4 mg/dl. El valor medio de glucosa en líquido amniótico en pacientes con corioamnionitis fue de 8.8 mg/dl (p< 0.0001). Se evidenció correlación de glucosa baja (menor de 14 mg/dl) y positividad del cultivo de líquido amniótico con sensibilidad del 87.7%>especificidad del 92.5%, VPP del 46% y valor predictivo negativo del 99%.CONCLUSION: La determinación de glucosa en líquido amniótico es una alternativa diagnóstica rápida y certera en la identificación de infección intraamniótica en pacientes con actividad uterina pretérmino.

show abstract

Glucose consumption by polymorphonuclear leukocytes in the cerebrospinal fluid of patients with bacterial meningitis

Cited by 6 publications

References 17 publications

Pleocytosis is not fully responsible for low CSF glucose in meningitis

Pleocytosis is not fully responsible for low CSF glucose in meningitis

Amniotic Fluid Glucose Concentration: A Marker for Infection in Preterm Labor and Preterm Premature Rupture of Membranes

Determinación de glucosa en líquido amniótico como valor predictivo de infección intraamniótica en pacientes con trabajo de parto pretérmino

Contact Info

Product

Resources

About