Predictive Value of Decoy Receptor 3 in Postoperative Nosocomial Bacterial Meningitis

Abstract

Nosocomial bacterial meningitis requires timely treatment, but what is difficult is the prompt and accurate diagnosis of this disease. The aim of this study was to assess the potential role of decoy receptor 3 (DcR3) levels in the differentiation of bacterial meningitis from non-bacterial meningitis. A total of 123 patients were recruited in this study, among them 80 patients being with bacterial meningitis and 43 patients with non-bacterial meningitis. Bacterial meningitis was confirmed by bacterial culture of cerebrospinal fluid (CSF) culture and enzyme-linked immunosorbent assay (ELISA) was used to detect the level of DcR3 in CSF. CSF levels of DcR3 were statistically significant between patients with bacterial meningitis and those with non-bacterial meningitis (p < 0.001). A total of 48.75% of patients with bacterial meningitis received antibiotic >24 h before CSF sampling, which was much higher than that of non-bacterial meningitis. CSF leucocyte count yielded the highest diagnostic value, with an area under the receiver operating characteristic curve (ROC) of 0.928, followed by DcR3. At a critical value of 0.201 ng/mL for DcR3, the sensitivity and specificity were 78.75% and 81.40% respectively. DcR3 in CSF may be a valuable predictor for differentiating patients with bacterial meningitis from those with non-bacterial meningitis. Further studies are needed for the validation of this study.

The combination of decoy receptor 3 and soluble triggering receptor expressed on myeloid cells-1 for the diagnosis of nosocomial bacterial meningitis

“…ROC curve and AUC were performed to determine the discriminative accuracy of CSF sTREM-1 and DcR3. Combined with the published data, CSF DcR3 yielded a higher discriminative value with an AUC of 0.831 [ 13 ]. The AUC of sTREM-1 for predicting bacterial meningitis was 0.756 (95% confidence intervals (CI) 0.673-0.839; p < 0.001, Figure 1 ).…”

“…Among the 123 patients recruited in this study, 80 patients were diagnosed with bacterial meningitis [ 13 ]. In patients with bacterial meningitis, 6 patients had external ventricular drain-related meningitis.…”

“…The levels of CSF DcR3 were significantly different between the groups of bacterial meningitis and non-bacterial meningitis. 44 patients received antibiotic >24 h before CSF sampling, among them 5 patients with non-bacterial meningitis and 39 patients with bacterial meningitis [ 13 ]. Concentrations of sTREM-1 in the patients with bacterial meningitis were significantly higher than those with non-bacterial meningitis (19.017 (0 –60.256) pg/mL vs. 0 (0–0) pg/mL, p < 0.001).…”

“…The mean age (mean ± SD) of 80 patients with bacterial meningitis was 43.75 ± 16.46 years. The area under the receiver operating characteristic (ROC) curve (AUC) of DcR3 was 0.831 [ 13 ]. The biomarkers associated with this study were CSF DcR3 and sTREM-1.…”

“…In addition, DcR3 can be a new potential biomarker for inflammatory disease, autoimmune diseases and cancer [ 8 - 12 ]. Our previous study has proved that levels of DcR3 are significantly elevated in patients with bacterial meningitis and it may act as a useful biomarker of bacterial meningitis [ 13 ].…”