Accuracy of cerebrospinal fluid and serum S100B protein in the diagnosis of bacterial meningitis in children

• Main Authors: Dewi Sutriani Mahalini, Anak Agung Raka Sudewi, Soetjiningsih Soetjiningsih, I Gde Raka Widiana
• Format: Article
• Language: English
• Published: DiscoverSys 2018-10-01
• Series: Bali Medical Journal
• Subjects: bacterial meningitis, biomarker,cerebrospinal fluid, diagnostic test, s100b
• Online Access: https://balimedicaljournal.org/index.php/bmj/article/view/1202
• ISSN: 2089-1180; 2302-2914

<p><strong>Background:</strong> The diagnosis of bacterial meningitis is very difficult because of the vague clinical presentation primarily in infants and children. The S100B protein is a brain neurochemistry that may a biomarkers of inflammatory process in the brain and it is thought to have relationship with neuron damage and oxidative stress in bacterial meningitis.</p><p><strong>Methods:</strong> In this study, we measured the levels of S100B protein in CSF and serum by using ELISA method, in children with suspected bacterial meningitis. The diagnosis of proven bacterial meningitis based on positive culture that confirmed the causing bacteria. We analyzed the data by using MedCalc-version 17.6 programe.</p><p><strong>Results:</strong> Eighty patients suspected bacterial meningitis included in this study, 47 (58.8%) male, and mean of age was 29.8 months (SD<span style="text-decoration: underline;">+</span>32.1).  Prevalence of proven bacterial meningitis were 21/80 (26.25%).  The main clinical symptoms were seizures, decreased of consciousness, clinically sepsis, positive meningeal sign, vomiting and focal neurologic deficits. The comparison of S100B_CSF levels between positive culture and negative culture were 31.4 (SD<span style="text-decoration: underline;">+</span>32.81) and 29.2 (SD<span style="text-decoration: underline;">+</span>27.13). A comparison of S100B_serum levels between positive culture and negative culture 114.1 (SD<span style="text-decoration: underline;">+</span>95.67) dan 74.9 (SD<span style="text-decoration: underline;">+</span>75.84). Area under curve (AUC) of S100B_CSF dan S100B_serum were 0.523 and 0.655, respectively. Levels of S100B_CSF protein <span style="text-decoration: underline;">&gt;</span>54 ng/L and S100B_serum<span style="text-decoration: underline;">&gt;</span>177 ng/L were optimal criteria for diagnosis bacterial meningitis with sensitivity  29% and 19%,  specificity 98% and 98%, respectively.</p><p><strong>Conclusion: </strong> Levels of S100B_CSF and S100B_serum protein have prospective value with high specificity to confirm the diagnosis of bacterial meningitis in children.  We can use S100B_serum as addition test for the diagnosis of bacterial meningitis in children if there is contraindication for lumbal puncture. <strong></strong></p>