Diagnosis Value Of Selected Biomarkers In 199 Cases Of Children Bacterial Meningitis-A Clinical Analysis

Objective: To explore the diagnosis value of serum and cerebrospinal fluid biomarkers in children bacterial meningitis(BM).Methods: 199 cases of bacterial meningitis in Children’s Hospital of Chongqing Medical University from October 2016 to October 2019 were enrolled in this retrospective study.Results:1.The culture-positive group showed higher occurrence of nick stiffness and subdural effusion than the culture-negative group,while the other clinical characteristics,such as age,fever,seizure,intracranial hypertension,disturbance of consciousness,presented no differences between the two groups.2.In the aspect of selected biomarkers,including serum CRP,PCT,WBC,cerebrospinal fluid glucose,protein,chloride,cerebrospinal fluid/serum glucose ratio,the biomarkers’ concentrations in culture-positive group change more significantly than culture-negative group.3.ROC curve analysis: comparing area under ROC curve(AUC),serum CRP reaches the highest(0.733)when using 35.5 mg/L as the threshold.The diagnostic sensitivity and specificity of serum CRP for differentiatingculture-positive cases were 81.8%and 60.4%,respectively.CSF glucose has a sensitivity of 50.9% and a specificity of 88.1% at the cut-off of 1.82mmol/L.4.Multiple logistic regression analysis: age<1 year,presenting symptoms of intracranial hypertension,elevated serum PCT and decreased CSF glucose,are more likely to develop subdural effusion in BM children.Conclusion:1.In our study,among 199 BM children with clinically diagnosed,there was no significant difference in clinical manifestations between the culture-positive group and culture-negative group,suggested that children with symptoms of infection,intracranial hypertension,and meningeal irritation,BM should be considered,and further examination should be arranged immediately.2.All the selected biomarkers’ concentrations in culture-positive group change more significantly than culture-negative group.3.Serum CRP,CSF glucose can differentiate culture-positive BM to some degree.4.In our study,age<1 year,presenting symptoms of intracranial hypertension,elevated serum PCT and decreased CSF glucose,are independent risk factors of subdural effusion in children with BM.