Abstract Ref Number = APCP401
ACCURACY OF S100B PROTEIN IN CEREBROSPINAL FLUID AND SERUM IN THE DIAGNOSIS OF BACTERIAL MENINGITIS IN CHILDREN
dr Dewi Sutriani Mahalini, SpA,Raka Sudewi,Soetjiningsih ,Raka Widiana
Pediatrics Departmen Medical Faculty Udayana University Denpasar Bali Indonesia Neurology Department, Medical Faculty, Udayana University, Denpasar, Bali, Indonesia Pediatrics Department, Medical Faculty, Udayana University, Denpasar, Bali, Indonesia Internal Medicine Department, Udayana University, Denpasar, Bali, Indonesia
Background : The diagnosis of bacterial meningitis is very difficult because of the vague clinical presentation primarily in infants and children. The S100B protein is a brain neurochemistry that may become biomarkers in inflammatory process of the brain and is thought to have relationship to the neuron damage and oxidative stress in bacterial meningitis
Material : In this study, we measured the levels of S100B protein in CSF and serum by using ELISA method, in children with suspected bacterial meningitis. The diagnosis of proven bacterial meningitis is based on positive culture that confirmed the bacteria. We analysis the data by using MedCalc-version 17.6 programe.
Results : Eighty patients suspected bacterial meningitis included in this study, 47 (58.8%) male, and means of age was 29.8 months (SD+32.1). Prevalence of proven bacterial meningitis were 21/80 (26.25%). The main clinical symptoms were seizures, decreased of consciousness, clinically sepsis, positive meningeal sign, vomiting and focal neurologic deficits. The comparison of S100BCSF protein levels between positive culture and negative culture were 31.40 (SD+32.81) and 29.22 (SD+27.13). A comparison of S100Bserum protein levels between positive culture and negative culture 114.12 (SD+95.67) dan 74.95 (SD+75.84), Area under curve (AUC) of S100BCSF dan S100Bserum were 0.523 and 0.655, respectively. Levels of S100BCSF protein >86 ng/L and S100Bserum >297 ng/L is optimal criteria for diagnosis bacterial meningitis with specificity 98% and 98%, respectively.
Conclusions : Levels of S100BCSF and S100Bserum protein have prospective value with high specificity to uphold the diagnosis of bacterial meningitis in children. We can use S100Bserum as addition for diagnosis of bacterial meningitis in children if there is contraindication for lumbal puncture.
Keywords: bacterial meningitis biomarker cerebrospinal fluid