title: Calprotectin and lactoferrin in the cerebrospinal fluid; biomarkers utilisable for differential diagnostics of bacterial and aseptic meningitis?
abstract: BACKGROUND
  The aim of our work was to assess the diagnostic contribution of calprotectin and lactoferrin determinations in the cerebrospinal fluid when distinguishing between bacterial and aseptic meningitides.
  
  
  METHODS
  In 23 patients with bacterial meningitis (BM) and in 50 patients with aseptic meningitis (AM), we determined the concentrations of calprotectin, lactoferrin and the conventional biomarkers like glucose, total protein, lactate and polynuclear count in the cerebrospinal fluid (CSF). The discriminative power of the various parameters studied was determined by means of receiver operating characteristic (ROC) curves: the area under the curve (AUC), sensitivity, specificity, the positive likelihood ratio (+LR), and the negative likelihood ratio (-LR).
  
  
  RESULTS
  The diagnostic efficiency of calprotectin, lactoferrin, lactate, and polynuclear count when distinguishing between bacterial and aseptic meningitides, expressed by ROC curve parameters, was as follows: AUC (0.736, 0.946, 0.932, 0.932), sensitivity (86.2, 96.6, 90.0, 89.7), specificity (58.5, 92.4, 87.0, 90.6), +LR (2.08, 12.8, 6.9, 9.50), -LR (0.24, 0.04, 0.11, 0.11), respectively. The optimal cut point for calprotectin and lactoferrin was 191 ng/mL and 17.8 ng/mL, respectively.
  
  
  CONCLUSIONS
  Our findings show, that the determination of lactoferrin in the CSF was diagnostically the most efficient marker in distinguishing between bacterial and viral meningitides. Calprotectin was far less efficient diagnostic marker. The polynuclear count and lactate concentration showed a very good diagnostic efficiency as well. The determination of protein and glucose was diagnostically less beneficial.
authors.forename: Milan
authors.initials: M
authors.lastname: Dastych
authors.forename: Jana
authors.initials: J
authors.lastname: Gottwaldová
authors.forename: Zdenka
authors.initials: Z
authors.lastname: Čermáková
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007781:Lactoferrin / Q000134:cerebrospinal fluid*; D039841:Leukocyte L1 Antigen Complex / Q000134:cerebrospinal fluid*; D008297:Male; D008582:Meningitis, Aseptic / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D007781:Lactoferrin