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CSF lactate for accurate diagnosis of community-acquired bacterial meningitis
CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diag...
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| Published in: | European journal of clinical microbiology & infectious diseases 2015-10, Vol.34 (10), p.2049-2055 |
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| cites | cdi_FETCH-LOGICAL-c518t-b350ed6393f3f2e7b3e05d666bde56f3d55035fe59d3b69d8843e97a56194dec3 |
| container_end_page | 2055 |
| container_issue | 10 |
| container_start_page | 2049 |
| container_title | European journal of clinical microbiology & infectious diseases |
| container_volume | 34 |
| creator | Giulieri, S. Chapuis-Taillard, C. Jaton, K. Cometta, A. Chuard, C. Hugli, O. Du Pasquier, R. Bille, J. Meylan, P. Manuel, O. Marchetti, O. |
| description | CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diagnostic accuracy of lactate and other CSF parameters in patients with microbiologically documented episodes was assessed by receiver operating characteristic (ROC) curves. The cut-offs with the best diagnostic performance were determined. Forty-five of 61 patients (74 %) had a documented bacterial (
n
= 18;
S. pneumoniae,
11;
N. meningitidis,
5; other, 2) or viral (
n
= 27 enterovirus, 21; VZV, 3; other, 3) etiology. CSF parameters were significantly different in bacterial vs. viral meningitis, respectively (
p
|
| doi_str_mv | 10.1007/s10096-015-2450-6 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1727691050</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1711540140</sourcerecordid><originalsourceid>FETCH-LOGICAL-c518t-b350ed6393f3f2e7b3e05d666bde56f3d55035fe59d3b69d8843e97a56194dec3</originalsourceid><addsrcrecordid>eNqFkU1LHTEUhoO01Kv1B7gpA924iU1yJslkKRetBcWFdh0yyZlLZD40mVn4781wtZSCdJNDOM_7hvAQcsrZOWdM_8jlNIoyLqmoJaPqgGx4DZLWoOET2TADNTVawCE5yvmRlUyj9RdyKJRohG7Mhtxu76-q3vnZzVh1U6qc90taLyG63TjlmKupq_w0DMsY5xfq_PMSE4aqLSFM0fXVgGMcd3GO-Sv53Lk-48nbPCa_ry4fttf05u7nr-3FDfWSNzNtQTIMCgx00AnULSCTQSnVBpSqgyAlA9mhNAFaZULT1IBGO6m4qQN6OCZn-96nND0vmGc7xOyx792I05It10Irw1mp-T_KuawZr1f0-z_o47SksXxkpZhhQgEUiu8pn6acE3b2KcXBpRfLmV212L0WW7TYVYtVJfPtrXlpBwx_Eu8eCiD2QC6rcYfpr6c_bH0F43aWhQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1710902633</pqid></control><display><type>article</type><title>CSF lactate for accurate diagnosis of community-acquired bacterial meningitis</title><source>Springer Link</source><creator>Giulieri, S. ; Chapuis-Taillard, C. ; Jaton, K. ; Cometta, A. ; Chuard, C. ; Hugli, O. ; Du Pasquier, R. ; Bille, J. ; Meylan, P. ; Manuel, O. ; Marchetti, O.</creator><creatorcontrib>Giulieri, S. ; Chapuis-Taillard, C. ; Jaton, K. ; Cometta, A. ; Chuard, C. ; Hugli, O. ; Du Pasquier, R. ; Bille, J. ; Meylan, P. ; Manuel, O. ; Marchetti, O.</creatorcontrib><description>CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diagnostic accuracy of lactate and other CSF parameters in patients with microbiologically documented episodes was assessed by receiver operating characteristic (ROC) curves. The cut-offs with the best diagnostic performance were determined. Forty-five of 61 patients (74 %) had a documented bacterial (
n
= 18;
S. pneumoniae,
11;
N. meningitidis,
5; other, 2) or viral (
n
= 27 enterovirus, 21; VZV, 3; other, 3) etiology. CSF parameters were significantly different in bacterial vs. viral meningitis, respectively (
p
< 0.001 for all comparisons): white cell count (median 1333 vs. 143/mm
3
), proteins (median 4115 vs. 829 mg/l), CSF/blood glucose ratio (median 0.1 vs. 0.52), lactate (median 13 vs. 2.3 mmol/l). ROC curve analysis showed that CSF lactate had the highest accuracy for discriminating bacterial from viral meningitis, with a cutoff set at 3.5 mmol/l providing 100 % sensitivity, specificity, PPV, NPV, and efficiency. CSF lactate had the best accuracy for discriminating bacterial from viral meningitis and should be included in the initial diagnostic workup of this condition.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-015-2450-6</identifier><identifier>PMID: 26282789</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Accuracy ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibiotics ; Bacteria ; Biomedical and Life Sciences ; Biomedicine ; Cohort Studies ; Cross Infection - diagnosis ; Documentation ; Emergency medical care ; Enterovirus ; Etiology ; Female ; Humans ; Infectious diseases ; Internal Medicine ; Laboratories ; Lactic Acid - blood ; Male ; Medical Microbiology ; Medicine ; Meningitis ; Meningitis, Bacterial - blood ; Meningitis, Bacterial - diagnosis ; Meningitis, Viral - blood ; Meningitis, Viral - diagnosis ; Middle Aged ; Mortality ; Nosocomial infection ; Nuclear polyhedrosis virus ; Prospective Studies ; Receptors, Colony-Stimulating Factor - blood ; Sensitivity and Specificity ; Steroids ; Streptococcus infections ; Streptococcus pneumoniae ; Switzerland ; Varicella-zoster virus ; Young Adult</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2015-10, Vol.34 (10), p.2049-2055</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-b350ed6393f3f2e7b3e05d666bde56f3d55035fe59d3b69d8843e97a56194dec3</citedby><cites>FETCH-LOGICAL-c518t-b350ed6393f3f2e7b3e05d666bde56f3d55035fe59d3b69d8843e97a56194dec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26282789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giulieri, S.</creatorcontrib><creatorcontrib>Chapuis-Taillard, C.</creatorcontrib><creatorcontrib>Jaton, K.</creatorcontrib><creatorcontrib>Cometta, A.</creatorcontrib><creatorcontrib>Chuard, C.</creatorcontrib><creatorcontrib>Hugli, O.</creatorcontrib><creatorcontrib>Du Pasquier, R.</creatorcontrib><creatorcontrib>Bille, J.</creatorcontrib><creatorcontrib>Meylan, P.</creatorcontrib><creatorcontrib>Manuel, O.</creatorcontrib><creatorcontrib>Marchetti, O.</creatorcontrib><title>CSF lactate for accurate diagnosis of community-acquired bacterial meningitis</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diagnostic accuracy of lactate and other CSF parameters in patients with microbiologically documented episodes was assessed by receiver operating characteristic (ROC) curves. The cut-offs with the best diagnostic performance were determined. Forty-five of 61 patients (74 %) had a documented bacterial (
n
= 18;
S. pneumoniae,
11;
N. meningitidis,
5; other, 2) or viral (
n
= 27 enterovirus, 21; VZV, 3; other, 3) etiology. CSF parameters were significantly different in bacterial vs. viral meningitis, respectively (
p
< 0.001 for all comparisons): white cell count (median 1333 vs. 143/mm
3
), proteins (median 4115 vs. 829 mg/l), CSF/blood glucose ratio (median 0.1 vs. 0.52), lactate (median 13 vs. 2.3 mmol/l). ROC curve analysis showed that CSF lactate had the highest accuracy for discriminating bacterial from viral meningitis, with a cutoff set at 3.5 mmol/l providing 100 % sensitivity, specificity, PPV, NPV, and efficiency. CSF lactate had the best accuracy for discriminating bacterial from viral meningitis and should be included in the initial diagnostic workup of this condition.</description><subject>Accuracy</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibiotics</subject><subject>Bacteria</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cohort Studies</subject><subject>Cross Infection - diagnosis</subject><subject>Documentation</subject><subject>Emergency medical care</subject><subject>Enterovirus</subject><subject>Etiology</subject><subject>Female</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Internal Medicine</subject><subject>Laboratories</subject><subject>Lactic Acid - blood</subject><subject>Male</subject><subject>Medical Microbiology</subject><subject>Medicine</subject><subject>Meningitis</subject><subject>Meningitis, Bacterial - blood</subject><subject>Meningitis, Bacterial - diagnosis</subject><subject>Meningitis, Viral - blood</subject><subject>Meningitis, Viral - diagnosis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nosocomial infection</subject><subject>Nuclear polyhedrosis virus</subject><subject>Prospective Studies</subject><subject>Receptors, Colony-Stimulating Factor - blood</subject><subject>Sensitivity and Specificity</subject><subject>Steroids</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae</subject><subject>Switzerland</subject><subject>Varicella-zoster virus</subject><subject>Young Adult</subject><issn>0934-9723</issn><issn>1435-4373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqFkU1LHTEUhoO01Kv1B7gpA924iU1yJslkKRetBcWFdh0yyZlLZD40mVn4781wtZSCdJNDOM_7hvAQcsrZOWdM_8jlNIoyLqmoJaPqgGx4DZLWoOET2TADNTVawCE5yvmRlUyj9RdyKJRohG7Mhtxu76-q3vnZzVh1U6qc90taLyG63TjlmKupq_w0DMsY5xfq_PMSE4aqLSFM0fXVgGMcd3GO-Sv53Lk-48nbPCa_ry4fttf05u7nr-3FDfWSNzNtQTIMCgx00AnULSCTQSnVBpSqgyAlA9mhNAFaZULT1IBGO6m4qQN6OCZn-96nND0vmGc7xOyx792I05It10Irw1mp-T_KuawZr1f0-z_o47SksXxkpZhhQgEUiu8pn6acE3b2KcXBpRfLmV212L0WW7TYVYtVJfPtrXlpBwx_Eu8eCiD2QC6rcYfpr6c_bH0F43aWhQ</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Giulieri, S.</creator><creator>Chapuis-Taillard, C.</creator><creator>Jaton, K.</creator><creator>Cometta, A.</creator><creator>Chuard, C.</creator><creator>Hugli, O.</creator><creator>Du Pasquier, R.</creator><creator>Bille, J.</creator><creator>Meylan, P.</creator><creator>Manuel, O.</creator><creator>Marchetti, O.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><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>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20151001</creationdate><title>CSF lactate for accurate diagnosis of community-acquired bacterial meningitis</title><author>Giulieri, S. ; Chapuis-Taillard, C. ; Jaton, K. ; Cometta, A. ; Chuard, C. ; Hugli, O. ; Du Pasquier, R. ; Bille, J. ; Meylan, P. ; Manuel, O. ; Marchetti, O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c518t-b350ed6393f3f2e7b3e05d666bde56f3d55035fe59d3b69d8843e97a56194dec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Accuracy</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibiotics</topic><topic>Bacteria</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cohort Studies</topic><topic>Cross Infection - diagnosis</topic><topic>Documentation</topic><topic>Emergency medical care</topic><topic>Enterovirus</topic><topic>Etiology</topic><topic>Female</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Internal Medicine</topic><topic>Laboratories</topic><topic>Lactic Acid - blood</topic><topic>Male</topic><topic>Medical Microbiology</topic><topic>Medicine</topic><topic>Meningitis</topic><topic>Meningitis, Bacterial - blood</topic><topic>Meningitis, Bacterial - diagnosis</topic><topic>Meningitis, Viral - blood</topic><topic>Meningitis, Viral - diagnosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nosocomial infection</topic><topic>Nuclear polyhedrosis virus</topic><topic>Prospective Studies</topic><topic>Receptors, Colony-Stimulating Factor - blood</topic><topic>Sensitivity and Specificity</topic><topic>Steroids</topic><topic>Streptococcus infections</topic><topic>Streptococcus pneumoniae</topic><topic>Switzerland</topic><topic>Varicella-zoster virus</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giulieri, S.</creatorcontrib><creatorcontrib>Chapuis-Taillard, C.</creatorcontrib><creatorcontrib>Jaton, K.</creatorcontrib><creatorcontrib>Cometta, A.</creatorcontrib><creatorcontrib>Chuard, C.</creatorcontrib><creatorcontrib>Hugli, O.</creatorcontrib><creatorcontrib>Du Pasquier, R.</creatorcontrib><creatorcontrib>Bille, J.</creatorcontrib><creatorcontrib>Meylan, P.</creatorcontrib><creatorcontrib>Manuel, O.</creatorcontrib><creatorcontrib>Marchetti, O.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest Biological Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>European journal of clinical microbiology & infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giulieri, S.</au><au>Chapuis-Taillard, C.</au><au>Jaton, K.</au><au>Cometta, A.</au><au>Chuard, C.</au><au>Hugli, O.</au><au>Du Pasquier, R.</au><au>Bille, J.</au><au>Meylan, P.</au><au>Manuel, O.</au><au>Marchetti, O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CSF lactate for accurate diagnosis of community-acquired bacterial meningitis</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>34</volume><issue>10</issue><spage>2049</spage><epage>2055</epage><pages>2049-2055</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diagnostic accuracy of lactate and other CSF parameters in patients with microbiologically documented episodes was assessed by receiver operating characteristic (ROC) curves. The cut-offs with the best diagnostic performance were determined. Forty-five of 61 patients (74 %) had a documented bacterial (
n
= 18;
S. pneumoniae,
11;
N. meningitidis,
5; other, 2) or viral (
n
= 27 enterovirus, 21; VZV, 3; other, 3) etiology. CSF parameters were significantly different in bacterial vs. viral meningitis, respectively (
p
< 0.001 for all comparisons): white cell count (median 1333 vs. 143/mm
3
), proteins (median 4115 vs. 829 mg/l), CSF/blood glucose ratio (median 0.1 vs. 0.52), lactate (median 13 vs. 2.3 mmol/l). ROC curve analysis showed that CSF lactate had the highest accuracy for discriminating bacterial from viral meningitis, with a cutoff set at 3.5 mmol/l providing 100 % sensitivity, specificity, PPV, NPV, and efficiency. CSF lactate had the best accuracy for discriminating bacterial from viral meningitis and should be included in the initial diagnostic workup of this condition.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26282789</pmid><doi>10.1007/s10096-015-2450-6</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0934-9723 1435-4373 |
| language | eng |
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| subjects | Accuracy Adolescent Adult Aged Aged, 80 and over Antibiotics Bacteria Biomedical and Life Sciences Biomedicine Cohort Studies Cross Infection - diagnosis Documentation Emergency medical care Enterovirus Etiology Female Humans Infectious diseases Internal Medicine Laboratories Lactic Acid - blood Male Medical Microbiology Medicine Meningitis Meningitis, Bacterial - blood Meningitis, Bacterial - diagnosis Meningitis, Viral - blood Meningitis, Viral - diagnosis Middle Aged Mortality Nosocomial infection Nuclear polyhedrosis virus Prospective Studies Receptors, Colony-Stimulating Factor - blood Sensitivity and Specificity Steroids Streptococcus infections Streptococcus pneumoniae Switzerland Varicella-zoster virus Young Adult |
| title | CSF lactate for accurate diagnosis of community-acquired bacterial meningitis |
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