Value of combined detection of cerebrospinal fluid lactate, interleukin-27 and interferon-γ in diagnosing bacterial meningitis after neurosurgical operation

Objective  To explore the value of combined detection of cerebrospinal fluid lactate (LA), interleukin-27 (IL-27) and interferon-γ (IFN-γ) in diagnosing bacterial meningitis after neurosurgical operation in Intensive Care Unit (ICU).

Methods  A total of 54 patients with bacterial meningitis after neurosurgical operation in ICU were collected as disease group, and 62 patients without bacterial meningitis after operation were collected as control group. Fully automated biochemical analyzer and enzyme-linked immunosorbent assay (ELISA) were used to detect the expression levels of LA, IL-27 and IFN-γ in cerebrospinal fluid; the Logistic regression model was used to analyze the related factors affecting bacterial meningitis after operation; the receiver operating characteristic (ROC) curve was used to analyze the diagnostic values of LA, IL-27 and IFN-γ in cerebrospinal fluid for bacterial meningitis after operation.

Results  The glucose level in the disease group was significantly lower than that in the control group, while the white blood cell count and protein level were significantly higher than those in the control group (P < 0.01). The expression levels of LA and IL-27 in the cerebrospinal fluid in the disease group were significantly higher than those in the control group, while IFN-γ level in the cerebrospinal fluid was significantly lower than that in the control group (P < 0.01). Logistic regression analysis showed that LA, IL-27 and IFN-γ in the cerebrospinal fluid were the influencing factors of bacterial meningitis after neurosurgical operation in ICU (P < 0.05). The area under the curve (AUC) of LA combined with IL-27 and IFN-γ in cerebrospinal fluid in the diagnosis of bacterial meningitis after neurosurgical operation in ICU was 0.955, which was better than that of single diagnosis based on LA (AUC=0.806, Z=4.029, P < 0.001), IL-27 (AUC=0.858, Z=2.513, P=0.012) and IFN-γ (AUC=0.815, Z=3.680, P < 0.001) in cerebrospinal fluid, and the sensitivity and specificity of the combined diagnosis were 87.04% and 93.55% respectively.

Conclusion  The expression levels of LA and IL-27 in the cerebrospinal fluid of patients with bacterial meningitis after neurosurgical operation in ICU increase significantly, while the expression level of IFN-γ in the cerebrospinal fluid is significantly lower. The combined detection of three indicators has higher diagnostic value for postoperative bacterial meningitis compared with single detection.