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Hepatocyte growth factor in cerebrospinal fluid differentiates community-acquired or nosocomial septic meningitis from other causes of pleocytosis
Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
Department of Clinical Sciences Malmö, Lunds University, Malmö.
Department of Clinical Sciences Malmö, Lunds University, Malmö.
, School of Health and Medical Sciences, Örebro University.
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2015 (English)In: Fluids and Barriers of the CNS, ISSN 2045-8118, E-ISSN 2045-8118, Vol. 12, no 1Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Due to anatomical restrictions, the inflammatory response to intracerebral bacterial infections exposes swollen brain tissues to pressure and ischemia, resulting in life-threatening damage. Rapid diagnosis and immediate empirical antibiotic therapy is highly important. However, diagnosing meningitis in patients after neurosurgery is complicated, due to brain tissue damage and changes in cerebrospinal fluid (CSF) caused by surgery. Hepatocyte growth factor (HGF) is a local, acute-phase protein with healing properties. Previous studies on community-acquired septic meningitis reported high levels of intrathecally produced HGF. The present study focused on nosocomial meningitis in assessing the levels of HGF in the CSF.

METHODS: HGF concentrations (ELISA) and HGF binding to receptors; c-Met receptor and heparan sulfate proteoglycan were determined in CSF samples (surface plasmon resonance). CSF samples from patients with community-acquired or nosocomial meningitis (217 samples from 135 patients) were compared to those from controls without signs of cerebral nervous system involvement (N = 36) and patients with Alzheimer's disease (N = 20).

RESULTS: Compared to samples from patients that had undergone neurosurgery and had other infectious diseases, CSF samples from patients with nosocomial meningitis had significantly higher HGF concentrations (p < 0.001) and binding affinity to c-Met (p < 0.001) and HSPG (p = 0.043) receptors. The sensitivity and specificity to identify nosocomial septic meningitis were 69.7 and 93.4 %, respectively. The HGF concentration and binding affinity to HGF receptors were significantly higher in CSF from patients with community-acquired septic meningitis compared to patients with aseptic (viral and subacute) meningitis as well as controls (p < 0.001). The sensitivity and specificity to identify community-acquired septic meningitis were 95.4 and 95.7 %, respectively.

DISCUSSION: In febrile nosocomial infections that occurred post neurosurgery, HGF assessment could substantially improve the differentiation of meningitis from other infections and therefore might be a tool for rapid diagnosis, limiting injuries and guiding antibiotic therapy.

Place, publisher, year, edition, pages
2015. Vol. 12, no 1
National Category
Infectious Medicine Pharmaceutical Sciences
URN: urn:nbn:se:liu:diva-122242DOI: 10.1186/s12987-015-0020-zPubMedID: 26408034OAI: diva2:864151
Available from: 2015-10-26 Created: 2015-10-26 Last updated: 2016-04-12

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Sjöwall, JohannaNayeri, Fariba
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Department of NeurosurgeryDivision of Microbiology and Molecular MedicineFaculty of Medicine and Health SciencesDepartment of Infectious Diseases
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Infectious MedicinePharmaceutical Sciences

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