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Intensive Care Medicine

, Volume 32, Issue 8, pp 1243–1247 | Cite as

Soluble triggering receptor expressed on myeloid cells 1: a biomarker for bacterial meningitis

  • Rogier M. Determann
  • Martijn Weisfelt
  • Jan de Gans
  • Arie van der Ende
  • Marcus J. Schultz
  • Diederik van de Beek
Brief Report

Abstract

Objective

To evaluate whether soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in CSF can serve as a biomarker for the presence of bacterial meningitis and outcome in patients with this disease.

Design

Retrospective study of diagnostic accuracy.

Setting and patients

CSF was collected from 92 adults with community-acquired bacterial meningitis who participated in the prospective Dutch Meningitis Cohort Study; 8 patients with viral meningitis and 9 healthy control subjects.

Results

CSF sTREM-1 levels were higher in patients with bacterial meningitis (median 82 pg/ml, range 0–988) than in those with viral meningitis (0 pg/ml, 0–48) and controls (0 pg/ml, 0–36). The diagnostic accuracy of sTREM-1 in discriminating between patients with and without bacterial meningitis, expressed as the area under the receiver operating characteristic curve, was 0.82. At a cutoff level of 20 pg/ml the sensitivity was 0.73 and specificity 0.77. In patients with bacterial meningitis CSF sTREM-1 levels were associated with mortality (survivors, median 73 pg/ml, range 0–449 pg/ml; nonsurvivors, 151 pg/ml, 0–988).

Conclusions

Measuring sTREM-1 in CSF may be a valuable new additional approach to accurately diagnose bacterial meningitis and identify patients at high risk for adverse outcome. Therefore a prospective study of sTREM-1 as a biomarker in bacterial meningitis is needed.

Keywords

Soluble triggering receptor expressed on myeloid cells 1 Bacterial meningitis Viral meningitis Cerebrospinal fluid Outcome 

Notes

Acknowledgements

We are indebted to many physicians in The Netherlands who participated in the Dutch Meningitis Cohort. We thank Frank Baas and Hans L. Zaaijer for their help finding control samples.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Rogier M. Determann
    • 1
  • Martijn Weisfelt
    • 2
  • Jan de Gans
    • 2
  • Arie van der Ende
    • 3
    • 4
  • Marcus J. Schultz
    • 1
  • Diederik van de Beek
    • 2
  1. 1.Department of Intensive Care Medicine, Center of Infection and Immunity Amsterdam, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Neurology, Center of Infection and Immunity Amsterdam, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Medical Microbiology, Center of Infection and Immunity Amsterdam, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.Netherlands Reference Laboratory of Bacterial Meningitis, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands

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