Value of lipocalin 2 as a potential biomarker for bacterial meningitis

• DOI: 10.1016/j.cmi.2020.07.006
• Publication Date: 2020-07-11T06:20:30Z
• Authors: T.T. Thanh; C. Casals-Pascual; N.T.H. Ny; N.M. Ngoc; R. Geskus; L.N.T. Nhu; N.T.T. Hong; D.T. Duc; D.D.A. Thu; P.N. Uyen; V.B. Ngoc; L.T.M. Chau; V.X. Quynh; N.H.H. Hanh; N.T.T. Thuong; L.T. Diem; B.T.B. Hanh; V.T.T. Hang; P.K.N. Oanh; R. Fischer; N.H. Phu; H.D.T. Nghia; N.V.V. Chau; N.T. Hoa; B.M. Kessler; G. Thwaites; L.V. Tan
• Keywords: CSF albumin

ObjectivesCentral nervous system (CNS) infections are common causes of morbidity and mortality worldwide. We aimed to discover protein biomarkers that could rapidly accurately identify the likely cause infections, essential for clinical management improving outcome.MethodsWe applied liquid chromatography tandem mass spectrometry on 45 cerebrospinal fluid (CSF) samples from a cohort adults with without CNS potential diagnostic biomarkers. then validated performance selected biomarker candidate in an independent 364 consecutively treated admitted referral hospital Vietnam.ResultsIn discovery cohort, we identified lipocalin 2 (LCN2) as bacterial meningitis (BM) other than tuberculous meningitis. The analysis validation showed LCN2 discriminate BM (including meningitis, cryptococcal virus/antibody-mediated encephalitis), sensitivity 0.88 (95% confident interval (CI), 0.77–0.94), specificity 0.91 CI, 0.88–0.94) odds ratio 73.8 31.8–171.4). outperformed CSF markers (leukocytes, glucose, lactate) commonly used routine care combination LCN2, leukocytes, lactate resulted highest (area under receiver operating characteristics curve, 0.96; 95% 0.93–0.99). Data available via ProteomeXchange identifier PXD020510.ConclusionsLCN2 is sensitive specific discriminating broad spectrum infections. A prospective study needed assess utility diagnosis