Soluble triggering receptor expressed on myeloid cells 1: a biomarker for bacterial meningitis.
OBJECTIVE
To evaluate whether soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in CSF can serve as a biomarker for the presence of bacterial meningitis and outcome in patients with this disease.


METHODS
Retrospective study of diagnostic accuracy.


METHODS
CSF was collected from 92 adults with community-acquired bacterial meningitis who participated in the prospective Dutch Meningitis Cohort Study; 8 patients with viral meningitis and 9 healthy control subjects.


RESULTS
CSF sTREM-1 levels were higher in patients with bacterial meningitis (median 82 pg/ml, range 0-988) than in those with viral meningitis (0 pg/ml, 0-48) and controls (0 pg/ml, 0-36). The diagnostic accuracy of sTREM-1 in discriminating between patients with and without bacterial meningitis, expressed as the area under the receiver operating characteristic curve, was 0.82. At a cutoff level of 20 pg/ml the sensitivity was 0.73 and specificity 0.77. In patients with bacterial meningitis CSF sTREM-1 levels were associated with mortality (survivors, median 73 pg/ml, range 0-449 pg/ml; nonsurvivors, 15 pg/ml, 0-988).


CONCLUSIONS
Measuring sTREM-1 in CSF may be a valuable new additional approach to accurately diagnose bacterial meningitis and identify patients at high risk for adverse outcome. Therefore a prospective study of sTREM-1 as a biomarker in bacterial meningitis is needed.
Determann
Rogier M
RM
Department of Intensive Care Medicine, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Weisfelt
Martijn
M
de Gans
Jan
J
van der Ende
Arie
A
Schultz
Marcus J
MJ
van de Beek
Diederik
D
D015415:Biomarkers / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D006801:Humans; D008562:Membrane Glycoproteins / Q000134:cerebrospinal fluid*; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D011971:Receptors, Immunologic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
D015415:Biomarkers; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1