ORIGINAL ARTICLE

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

Dewi Sutriani Mahalini , Anak Agung Raka Sudewi, Soetjiningsih Soetjiningsih, I Gde Raka Widiana

Dewi Sutriani Mahalini
Pediatrics Department, Faculty of Medicine, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia. Email: dewi.sutriani@yahoo.com

Anak Agung Raka Sudewi
Neurology Department, Faculty of Medicine, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia.

Soetjiningsih Soetjiningsih
Pediatrics Department, Faculty of Medicine, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia

I Gde Raka Widiana
Internal Medicine Department, Faculty of Medicine, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia.
Online First: October 03, 2018 | Cite this Article
Mahalini, D., Sudewi, A., Soetjiningsih, S., Widiana, I. 2018. Accuracy of cerebrospinal fluid and serum S100B protein in the diagnosis of bacterial meningitis in children. Bali Medical Journal 7(3). DOI:10.15562/bmj.v7i3.1202


Background: 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.

Methods: 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.

Results: Eighty patients suspected bacterial meningitis included in this study, 47 (58.8%) male, and mean of age was 29.8 months (SD+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 S100BCSF levels between positive culture and negative culture were 31.4 (SD+32.81) and 29.2 (SD+27.13). A comparison of S100Bserum levels between positive culture and negative culture 114.1 (SD+95.67) dan 74.9 (SD+75.84). Area under curve (AUC) of S100BCSF dan S100Bserum were 0.523 and 0.655, respectively. Levels of S100BCSF protein >54 ng/L and S100Bserum >177 ng/L were optimal criteria for diagnosis bacterial meningitis with sensitivity  29% and 19%,  specificity 98% and 98%, respectively.

Conclusion:  Levels of S100BCSF and S100Bserum protein have prospective value with high specificity to confirm the diagnosis of bacterial meningitis in children.  We can use S100Bserum as addition test for the diagnosis of bacterial meningitis in children if there is contraindication for lumbal puncture.

References

SWAB. Guidelines on Antibacterial Therapy of Patients With Bacterial Central Nervous System Infections. 2012.Diunduh dari: www.swab.nl

Brouwer MC Tunkel AR, Van De Beek D Epidemiology, diagnosis and Antimicrobial Treatment of Acute Bacterial Meningitis. Clin Microbiol Rev. 2010 23: 467-492.

Van de Beek D. Progress and Chellenges in Bacterial Meningitis. The lancet com. 2012; 380: 1623-1624.

Yardan T, Erenler A, Baydin A, Aydin K, Cokluk C. Usefulness of S100B Protein in Neurological Disorders. J Pak med Assoc,2011.; 61(3): 276-28.

SA, Hamed Hamed EA, Zakary MM. Oxidative Stess and S100B proteins in Children with Bacterial Meningitis. BMC Neurology. 2009; 9: 51.

Sen J, Belli A. S100B in Neuropathologic States: The CRP of the brain? J. Neurosci .Res. 2007; 85: 1373-1380.

Michetti F, Corvino V, Geloso MC, Lattanzi W, Bernardini C, Serpero L, Gazzolo D. The S100B Protein in Biological Fluids: More than A Lifelong Biomarker of Brain Distress. J. Neurochem, 2012;120: 644-59.

Donato R, Sorci G, Riuzzi F, Arcuri C, Bianchi R, Brozzi F, et al. S100B's Double Life: Intracellular Regulator and Extracellular Signal. Biochimica et Biophysica Acta. 2009; 1922:1008-1022.

Spinella, Donoghue A, Rajendra A, Drott HR, Dominguez TE, Helfaer M. Cerebrospinal fluid Fluid Levels of S100B in Children and Its Elevation in Pediatric Meningitis. Pediatr Crit Care Med. 2004; 5(1): 53-57.

Kepa L, Oczko-Grzesik B. Evaluation of Cerebrospinal Fluid S100B Protein Concentration in Patients with Purulent, Bacterial Meningitis-own Observations. Przegl Epidemiol, 2013; 67: 415-419.

Peng QL, Tao SH, Yu N, Zhou XZ, Peng YZ, Fu N. Elevated levels of the cerebrospinal fluid Fluid S100B acres Associated with traumatic injury and Unfavorable outcomes in children with Central Nervous System Management. Int J Neurosci. 2017; 127(1): 1-9. DOI: 10.3109/00207454.2015.1135334.

Petzold A, Keir G, Lim D, Smith M, Thompson EJ. Cerebrospinal fluid fluid (CSF) and serum S100B: release and wash-out pattern. Brain Research Bulletin. 2003; 61(3): 281-285.

Portela LV, Tort AB, Schaf get enough, Ribeiro L, Nora DB, Walz R, et al. The Serum S100B -is Age Dependent. Clin Chem. 2002; 48(6):950-952.

Bouvier D, Castellani C, Fournier M, Dauphin J, Ughetto S, Breton M, Labbé A, Weinberg A & Sapin V. Reference Ranges for Serum S100B Proteins Te The First Three Years of Life. Clinical biochemistry. 2011; 44(10-11): 927-929.

Gazzolo D, Grutzfeld D, Michetti F, Toesca A, Lituanian M, Bruschettini M, et al. Increased S100B in cerebrospinal fluid Fluid of Infants With Bacterial Meningitis: Relathionship to Brain Damage and Routine cerebrospinal fluid Fluid Findings. Clinical Chemistry. 2004; 50(5): 941-944.

Unden J, Christensson B, Bellner J, Alling C, Romner B. Serum S100B Levels in Variability with the Cerebral and Extracerebral Infectious Disease. Scand J Infect Dis. 2004; 36(1):10-13.


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