Lishan Yin1, Yipeng Han2, Guozhuan Miao3, Lin Jiang4, Sen Xie5, Baiyun Liu6. 1. Department of Neurotrauma, General Hospital of Chinese People's Armed Police Force, No. 69 Yongding Road, Haidian District, Beijing, China. Electronic address: doctor_yinls@163.com. 2. Department of Neurotrauma, General Hospital of Chinese People's Armed Police Force, No. 69 Yongding Road, Haidian District, Beijing, China. Electronic address: hanyipeng79@163.com. 3. Department of Neurotrauma, General Hospital of Chinese People's Armed Police Force, No. 69 Yongding Road, Haidian District, Beijing, China. Electronic address: miaogh@sina.com. 4. Department of Neurotrauma, General Hospital of Chinese People's Armed Police Force, No. 69 Yongding Road, Haidian District, Beijing, China. Electronic address: 707017399@qq.com. 5. Department of Neurotrauma, General Hospital of Chinese People's Armed Police Force, No. 69 Yongding Road, Haidian District, Beijing, China. Electronic address: Xiesen666@126.com. 6. Department of Neurotrauma, General Hospital of Chinese People's Armed Police Force, No. 69 Yongding Road, Haidian District, Beijing, China; Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Beijing, China; Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Beijing Key Laboratory of Central Nervous System Injury, Beijing, China. Electronic address: liubaiyun12@163.com.
Abstract
OBJECT: This paper is aimed to explore a reasonable guideline for distinguishing whether post-neurosurgical bacterial meningitis has completely been cured, so as to avoid the deficient or excessive treatment for post-neurosurgical bacterial meningitis. PATIENTS AND METHODS: We conducted a retrospective analysis of 46 patients who attended General Hospital of Chinese People's Armed Police Force in Beijing, China, from January 1, 2014 to April 30, 2016. The CSF leukocyte, polykaryocyte, protein and glucose had been tested when their antibiotic treatments were empirically stopped. Between the non-relapse and relapse groups, Wilcoxon Rank Sum test was used to compare the differences of CSF leukocyte and polykaryocyte, and t-test was applied to contrast the distinctions of CSF protein and glucose, then, the thresholds of significant items were estimated by ROC curve. RESULTS: The CSF leukocyte counts in non-relapse group are 23.72 ± 14.12/mm3, which are statistically less than the relapse group's (47.00 ± 1.00/mm3, P = 0.014), so does the CSF polykaryocyte counts (1.74 ± 4.84/mm3 &4.67 ± 1.15/mm3, P = 0.012). Between the two groups, the AUCs of leucocyte and polykaryocyte are 0.926 (95% CI = 0.845-1.0, P = 0.014) and 0.884 (95%CI = 0.786-0.982, P = 0.028), respectively. Their critical values are 44/mm3 (sensitivity = 1, specificity = 0.907) and 3/mm3 (sensitivity = 1, specificity = 0.837). Conversely, CSF protein and glucose have no statistic differences between the two groups. CONCLUSION: Both CSF leukocyte and polykaryocyte can satisfactorily indicate whether the post-neurosurgical bacterial meningitis has completely been cured, 0-44/mm3 is recommended as the reference range of CSF leukocyte, and the CSF polykaryocyte' s is 0-3/mm3.
OBJECT: This paper is aimed to explore a reasonable guideline for distinguishing whether post-neurosurgical bacterial meningitis has completely been cured, so as to avoid the deficient or excessive treatment for post-neurosurgical bacterial meningitis. PATIENTS AND METHODS: We conducted a retrospective analysis of 46 patients who attended General Hospital of Chinese People's Armed Police Force in Beijing, China, from January 1, 2014 to April 30, 2016. The CSF leukocyte, polykaryocyte, protein and glucose had been tested when their antibiotic treatments were empirically stopped. Between the non-relapse and relapse groups, Wilcoxon Rank Sum test was used to compare the differences of CSF leukocyte and polykaryocyte, and t-test was applied to contrast the distinctions of CSF protein and glucose, then, the thresholds of significant items were estimated by ROC curve. RESULTS: The CSF leukocyte counts in non-relapse group are 23.72 ± 14.12/mm3, which are statistically less than the relapse group's (47.00 ± 1.00/mm3, P = 0.014), so does the CSF polykaryocyte counts (1.74 ± 4.84/mm3 &4.67 ± 1.15/mm3, P = 0.012). Between the two groups, the AUCs of leucocyte and polykaryocyte are 0.926 (95% CI = 0.845-1.0, P = 0.014) and 0.884 (95%CI = 0.786-0.982, P = 0.028), respectively. Their critical values are 44/mm3 (sensitivity = 1, specificity = 0.907) and 3/mm3 (sensitivity = 1, specificity = 0.837). Conversely, CSF protein and glucose have no statistic differences between the two groups. CONCLUSION: Both CSF leukocyte and polykaryocyte can satisfactorily indicate whether the post-neurosurgical bacterial meningitis has completely been cured, 0-44/mm3 is recommended as the reference range of CSF leukocyte, and the CSF polykaryocyte' s is 0-3/mm3.