Abstract：
OBJECTIVE: Nosocomial ventriculitis is a difficult infectious condition to diagnose given that typical cerebral spinal fluid (CSF) parameters, commonly used in the diagnosis of meningitis, lack sensitivity and specificity in nosocomial ventriculitis. Consequently, novel diagnostics are needed to aid in diagnosing this condition. Herein a pilot study using alpha-defensins (α-defensins) to diagnose ventriculitis is discussed.
METHODS: From May 01, 2022, to December 30, 2022, ten patients with culture-proven external ventricular drain (EVD)-associated ventriculitis and ten patients without EVD-associated ventriculitis had CSF preserved. Levels of α-defensins were compared between the two cohorts with enzyme-linked immunosorbent assay.
RESULTS: There was a statistically significant (P ˂0.0001) higher level of CSF α-defensins in the ventriculitis cohort compared to the non-ventriculitis cohort. The levels of α-defensins were not affected by blood in CSF or bacterial virulence. Patients with other infectious conditions had increased levels of α-defensins but these levels were still statistically significantly (P ˂0.001) less than those seen in the ventriculitis cohort.
CONCLUSIONS: This pilot study shows that α-defensins have promise as a biomarker to aid in the diagnosis of ventriculitis. If larger studies support the findings here, this biomarker can help improve diagnostic accuracy and decrease unwarranted empirical broad-spectrum antibiotic use in suspected EVD-associated ventriculitis.
METHODS: From May 01, 2022, to December 30, 2022, ten patients with culture-proven external ventricular drain (EVD)-associated ventriculitis and ten patients without EVD-associated ventriculitis had CSF preserved. Levels of α-defensins were compared between the two cohorts with enzyme-linked immunosorbent assay.
RESULTS: There was a statistically significant (P ˂0.0001) higher level of CSF α-defensins in the ventriculitis cohort compared to the non-ventriculitis cohort. The levels of α-defensins were not affected by blood in CSF or bacterial virulence. Patients with other infectious conditions had increased levels of α-defensins but these levels were still statistically significantly (P ˂0.001) less than those seen in the ventriculitis cohort.
CONCLUSIONS: This pilot study shows that α-defensins have promise as a biomarker to aid in the diagnosis of ventriculitis. If larger studies support the findings here, this biomarker can help improve diagnostic accuracy and decrease unwarranted empirical broad-spectrum antibiotic use in suspected EVD-associated ventriculitis.
摘要：
背景：给定典型的CSF参数，医院性脑室炎是一种难以诊断的感染性疾病，通常用于诊断脑膜炎，对医院性脑室炎缺乏敏感性和特异性。因此,需要新的诊断来帮助诊断这种情况。本文讨论了使用α防御素诊断脑室炎的初步研究。
方法：从2022年5月1日至2022年12月30日，10例培养证实为EVD相关脑室炎的患者和10例无EVD相关脑室炎的患者保留了脑脊液。通过酶联免疫吸附试验比较了两个队列之间的α-防御素水平。
结果：与非脑室炎队列相比，脑室炎队列中脑脊髓液α-防御素水平有统计学意义（P=0.0001）。α-防御素的水平不受脑脊液中血液或细菌毒力的影响。其他感染性疾病患者的α-防御素水平升高，但这些水平仍比脑室炎队列中的水平低（P=0.001）。
结论：这项初步研究表明，α-防御素有望作为辅助诊断脑室炎的生物标志物。如果更大的研究支持这里的发现，该生物标志物有助于提高疑似EVD相关脑室炎的诊断准确性,减少不必要的经验性广谱抗生素使用.
方法：从2022年5月1日至2022年12月30日，10例培养证实为EVD相关脑室炎的患者和10例无EVD相关脑室炎的患者保留了脑脊液。通过酶联免疫吸附试验比较了两个队列之间的α-防御素水平。
结果：与非脑室炎队列相比，脑室炎队列中脑脊髓液α-防御素水平有统计学意义（P=0.0001）。α-防御素的水平不受脑脊液中血液或细菌毒力的影响。其他感染性疾病患者的α-防御素水平升高，但这些水平仍比脑室炎队列中的水平低（P=0.001）。
结论：这项初步研究表明，α-防御素有望作为辅助诊断脑室炎的生物标志物。如果更大的研究支持这里的发现，该生物标志物有助于提高疑似EVD相关脑室炎的诊断准确性,减少不必要的经验性广谱抗生素使用.
