Increased S100B in cerebrospinal fluid of infants with bacterial meningitis: relationship to brain damage and routine cerebrospinal fluid findings.

Abstract

Perinatal infections such as bacterial meningitis (BM) are one of the major factors associated with perinatal brain damage (1)(2)(3)(4). Despite accurate monitoring, the early stages of meningitis are crucial because brain damage may occur at a subclinical stage when ultrasound assessment is still silent (5)(6). Laboratory assessment is based on chemical analysis of cerebrospinal fluid (CSF) and the detection of bacteria, and the possibility of detecting cases at risk of brain damage is to date limited. The measurement of brain constituents able to diagnose subclinical lesions at this stage could therefore be useful. S100B is a calcium-binding protein primarily present in nervous tissue (7)(8)(9). Increased S100B in biological fluids has been shown to be a marker of brain damage both in adults and during the antenatal and postnatal periods (10)(11)(12)(13)(14)(15)(16). The present case–control study is aimed at investigating whether the measurement of S100B in CSF could also be useful in infants with BM for the early detection of cases at risk of encephalitis. Samples of CSF were collected from infants consecutively admitted between April 1998 and June 2000 to our tertiary referral center for intensive care for infectious diseases. For the present study we identified from our database 44 patients with BM and matched them for gestational age at sampling with 44 patients without BM (1 BM case vs 1 control). We retrieved clinical, laboratory, and routine CSF test data and CSF S100B concentrations. Eligibility criteria for infants with BM were as follows: clinical (respiratory distress, lethargy, presence/absence of minor/major neurologic symptoms, feeding and abdominal distension problems, temperature instability or increases, unexplained recurrent hypoglycemia, poor vascular perfusion) and laboratory signs of septicemia with altered CSF …