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

Abstract

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.