Accuracy of heparin binding protein: as a new marker in prediction of acute bacterial meningitis

ABSTRACT Background: Cerebrospinal fluid bacterial culture is the gold-standard for confirmation of acute bacterial meningitis, but many cases are not culture confirmed. Antibiotics reduce the chance of a microbiological diagnosis. Objective to evaluate efficacy of Heparin-binding protein in diagnosis of bacterial meningitis. Patients: 30 patients diagnosed with acute bacterial meningitis, 30 viral meningitis, and 30 subjects with normal CSF findings. Design: Diagnosis was based on history, clinical criteria, CSF examination, latex agglutination & culture, and sensitivities and response to therapy. HBP was measured using enzyme-linked immunosorbent technique in both serum & CSF. Results: Cerebrospinal fluid HBP levels averaged 0.82 ± 0.3 ng/mL in controls, 3.3 ± 1.7 ng/mL in viral and 174.8 ± 46.7 ng/mL in bacterial meningitis. Mean serum level was 0.84 ± 0.3 ng/mL in the controls, 3.7 ± 1.9 ng/mL in viral, and 192.2 ± 56.6 ng/mL in bacterial meningitis. Both HBP levels were significantly higher in patients with bacterial meningitis. Cut-offs of 56.7 ng/ml and 45.3 ng/ml in cerebrospinal fluid & serum showed 100% overall accuracy. Even in patients who received prior antibiotics, remained elevated. Conclusion: Serum Heparin-binding protein serves as a non-invasive potential marker of acute bacterial meningitis even in partially treated cases.

Accuracy of heparin binding protein: as a new marker in prediction of acute bacterial meningitis

ABSTRACT Background: Cerebrospinal fluid bacterial culture is the gold-standard for confirmation of acute bacterial meningitis, but many cases are not culture confirmed. Antibiotics reduce the chance of a microbiological diagnosis. Objective to evaluate efficacy of Heparin-binding protein in diagnosis of bacterial meningitis. Patients: 30 patients diagnosed with acute bacterial meningitis, 30 viral meningitis, and 30 subjects with normal CSF findings. Design: Diagnosis was based on history, clinical criteria, CSF examination, latex agglutination & culture, and sensitivities and response to therapy. HBP was measured using enzyme-linked immunosorbent technique in both serum & CSF. Results: Cerebrospinal fluid HBP levels averaged 0.82 ± 0.3 ng/mL in controls, 3.3 ± 1.7 ng/mL in viral and 174.8 ± 46.7 ng/mL in bacterial meningitis. Mean serum level was 0.84 ± 0.3 ng/mL in the controls, 3.7 ± 1.9 ng/mL in viral, and 192.2 ± 56.6 ng/mL in bacterial meningitis. Both HBP levels were significantly higher in patients with bacterial meningitis. Cut-offs of 56.7 ng/ml and 45.3 ng/ml in cerebrospinal fluid & serum showed 100% overall accuracy. Even in patients who received prior antibiotics, remained elevated. Conclusion: Serum Heparin-binding protein serves as a non-invasive potential marker of acute bacterial meningitis even in partially treated cases.

Accuracy of Combined Maternal Serum Interleukin-8 and Salivary Estriol in Prediction of Preterm Labor.

Aim: To assess the accuracy of combined maternal serum interleukin and maternal salivary estriol levels in prediction of preterm labor in Egyptian pregnant females. Study Design: Case control study. Place and Duration of Study: It was conducted in El-Shatby University Hospital of Gynecology and Obstetrics, Alexandria, Egypt between 1st Jan to 30th September in the year 2012. Methodology: We included 80 pregnant females of gestational age 28-36 weeks (40 females with preterm labor and 40 pregnant not in labor). Both groups were matched for the women's age and the gestational age. A questionnaire was completed; abdominal and vaginal examinations were done. Maternal serum and saliva were collected for measuring the serum interleukin-8 and salivary estriol levels using ELISA technique. Results: Using ROC curve analysis, the overall diagnostic accuracy of Salivary Estriol alone at cut off point 200 pg/ml in prediction of preterm labor was 58% (0.46-0.71). Sensitivity and specificity were 82.5% and 32.5% respectively. The diagnostic accuracy of combined Salivary Estriol and serum interleukin-8 in prediction of preterm labor was 68% (0.56-0.79). Sensitivity and specificity were 75%% and 60% respectively. Lastly, the maternal serum interleukin-8 had the following accuracy measures for prediction of preterm labor at cut off point 965 pg/ml. (Overall accuracy: 79% (0.69-0.89), sensitivity 92.5% and specificity 42.5%). Conclusion: The maternal serum interleukin-8 is an effective and relatively non invasive and more accurate strategy for prediction of preterm labor at cut off point 965 pg/ml than salivary estriol. (Overall accuracy: 79%, sensitivity 92.5% and specificity 42.5%).