Skip to main content

Advertisement

SpringerLink
Log in

Soluble triggering receptor expressed on myeloid cells 1: a biomarker for bacterial meningitis

  • Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

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.

Design

Retrospective study of diagnostic accuracy.

Setting and patients

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, 151 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M (2004) Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351:1849–1859

    Article  PubMed  CAS  Google Scholar 

  2. de Gans J, van de Beek D (2002) Dexamethasone in adults with bacterial meningitis. N Engl J Med 347:1549–1556

    Article  PubMed  CAS  Google Scholar 

  3. Bouchon A, Facchetti F, Weigand MA, Colonna M (2001) TREM-1 amplifies inflammation and is a crucial mediator of septic shock. Nature 410:1103–1107

    Article  PubMed  CAS  Google Scholar 

  4. Gibot S, Cravoisy A, Levy B, Bene MC, Faure G, Bollaert PE (2004) Soluble triggering receptor expressed on myeloid cells and the diagnosis of pneumonia. N Engl J Med 350:451–458

    Article  PubMed  CAS  Google Scholar 

  5. Gibot S, Kolopp-Sarda MN, Bene MC, Cravoisy A, Levy B, Faure GC, Bollaert PE (2004) Plasma level of a triggering receptor expressed on myeloid cells-1: its diagnostic accuracy in patients with suspected sepsis. Ann Intern Med 141:9–15

    PubMed  CAS  Google Scholar 

  6. Determann RM, Millo JL, Gibot S, Korevaar JC, Vroom MB, van der Poll T, Garrard CS, Schultz MJ (2005) Serial changes in soluble triggering receptor expressed on myeloid cells in the lung during development of ventilator-associated pneumonia. Intensive Care Med 31:1495–1500

    Article  PubMed  Google Scholar 

  7. Weisfelt M, Determann RM, de Gans J, van der Ende A, Schultz MJ, van de Beek D. sTREM-1 as a marker for bacterial meningitis. Presented as poster at the 16th European Congress of Clinical Microbiology and Infectious Diseases

  8. Spanos A, Harrell FE Jr, Durack DT (1989) Differential diagnosis of acute meningitis. An analysis of the predictive value of initial observations. JAMA 262:2700–2707

    Article  PubMed  CAS  Google Scholar 

  9. Tunkel AR (2001) Bacterial meningitis. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  10. Brivet FG, Ducuing S, Jacobs F, Chary I, Pompier R, Prat D, Grigoriu B, Normann P (2005) Accuracy of clinical presentation for differentiating bacterial from viral meningitis in adults. A multivariate approach. Intensive Care Med 31:1654–1660

    Article  PubMed  Google Scholar 

  11. Hoen B, Viel JF, Paquot C, Gerard A, Canton P (1995) Multivariate approach to differential diagnosis of acute meningitis. Eur J Clin Microbiol Infect Dis 14:267–274

    Article  PubMed  CAS  Google Scholar 

  12. Nigrovic LE, Kuppermann N, Malley R (2002) Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era. Pediatrics 110:712–719

    Article  PubMed  Google Scholar 

  13. Täuber MG, Kennedy SL, Tureen JH, Lowenstein DH (1992) Experimental pneumococcal meningitis causes central nervous system pathology without inducing the 72-kd heat shock protein. Am J Pathol 141:53–60

    PubMed  Google Scholar 

Download references

Acknowledgements

We are indebted to many physicians in The Netherlands who participated in the Dutch Meningitis Cohort. We thank Frank Baas and Hans L. Zaaijer for their help finding control samples.

Author information

Authors and Affiliations

  1. Department of Intensive Care Medicine, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Rogier M. Determann & Marcus J. Schultz

  2. Department of Neurology, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands

    Martijn Weisfelt, Jan de Gans & Diederik van de Beek

  3. Department of Medical Microbiology, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Arie van der Ende

  4. Netherlands Reference Laboratory of Bacterial Meningitis, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Arie van der Ende

Authors
  1. Rogier M. Determann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martijn Weisfelt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan de Gans
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arie van der Ende
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcus J. Schultz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Diederik van de Beek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Diederik van de Beek.

Additional information

R.M. Determann and M. Weisfelt contributed equally to this manuscript

The Dutch Meningitis Cohort was in part supported by a research grant from Roche Pharmaceuticals, The Netherlands. The study was designed, performed, and analyzed without any influence of pharmaceutical companies.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Determann, R.M., Weisfelt, M., de Gans, J. et al. Soluble triggering receptor expressed on myeloid cells 1: a biomarker for bacterial meningitis. Intensive Care Med 32, 1243–1247 (2006). https://doi.org/10.1007/s00134-006-0240-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-006-0240-4

Keywords

Search

Navigation