The clinical diagnostic significance of cerebrospinal fluid D-lactate for bacterial meningitis.
BACKGROUND
To study the clinical and laboratory significance of D‐lactate in the diagnosis of bacterial meningitis (BM).


METHODS
The levels of D‐lactate, L‐lactate, IL-6, IL-8, and other biochemical markers were determined in 83 CSF samples from different types of meningitis and the controls.


RESULTS
The CSF values of D‐lactate, L‐lactate, IL-6, IL-8, erythrocytes, leukocytes, and protein were higher in patients with BM than those in the controls and patients with viral meningitis. The levels of D‐lactate, L‐lactate, IL-6, and erythrocytes in the BM group were higher than those in the tuberculous meningitis group. At the cutoff 12.8 μmol/l, D‐lactate showed the diagnostic sensitivity of 94.7%. D‐lactate gave the area under the curve (AUC) 0.905, which was higher than those of other markers. Using multiple marker detection, the AUC reached 0.956, which was the highest among all the parameters. Pearson correlation analysis revealed that D‐lactate was positively correlated to IL-6 and L‐lactate (r=0.727, 0.789 and P=0.000, 0.000, respectively).


CONCLUSIONS
THE CSF concentrations of D‐lactate are significantly increased in the presence of BM. Measurement of D‐lactate provides a rapid diagnosis and differential diagnosis for BM. Combination of D‐lactate with other biochemical markers improves the specificity.
Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
Zengqiang
Z
Chen
Yumin
Y
Wang
Aibing
A
Zeng
Lijiang
L
Chen
Ruihao
R
Wu
Bicheng
B
Chen
Mengquan
M
Chen
Jinshuang
J
Bo
Hu
H
Zhang
Qian
Q
Peng
Jianxin
J
Lu
Qing H
QH
Meng
D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D016209:Interleukin-8 / Q000134:cerebrospinal fluid; D019344:Lactic Acid / Q000134:cerebrospinal fluid*; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000821:virology; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013237:Stereoisomerism; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000382:microbiology
D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D019344:Lactic Acid