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Subject Area

Endemic and Tropical Medicine

Article Type

Original Study

Abstract

Background Early diagnosis of meningitis and differentiation of bacterial from nonbacterial plays an important role in the effective treatment of patients. Objectives To evaluate the role of serum and cerebrospinal fluid (CSF) heparin-binding protein (HBP) in early diagnosis of acute bacterial meningitis (ABM) and its efficacy in differentiating acute bacterial from non-BM. Patients and methods This was a case–control study performed between January 2020 and April 2021. It included 65 patients with ABM, 48 patients with acute non-BM, and 20 healthy persons. Diagnosis of meningitis was based on history, clinical criteria, and CSF examination and culture. HBP was measured using enzyme-linked immunosorbent technique in both serum and CSF. Results CSF HBP mean levels were 73.11 ± 58.11 ng/ml in bacterial and 2.08 ± 4.36 ng/ml in non-BM. Both serum and CSF HBP levels were significantly higher in patients with acute bacterial than non-BM. Serum HBP was 55.42 ± 43.27 ng/ml in ABM and 1.85 ± 4.25 ng/ml in acute non-BM. At a cutoff point of 32.8 and 37.65 ng/ml in serum and CSF, respectively, HBP can predict ABM with accuracy of 81.2 and 80.2%, sensitivity of 67.7 and 67.6%, positive predictive value of 100 and 99.9%, negative predictive value of 69.6 and 70.5%, and area under curve of 0.812 and 0.802 in serum and CSF, respectively, with specificity of 100% in both serum and CSF. Conclusion HBP in either serum or CSF is a promising biomarker in differentiating acute bacterial from non-BM.

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