Purpose: Given the challenge in the diagnosis of bacterial meningitis (BM), we assessed different cytokines in the cerebrospinal fluid (CSF) of antibiotics pre-treated patients.Materials and methods: Laboratory tests and polymerase chain reaction (PCR) were performed for 480 CSF samples from children (2 m to 14 y), suspicious to meningitis and pre-treated with antibiotics, to detect bacterial and viral aetiologies. Sixty-one CSF were included and the levels of 13 cytokines such as IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-17A, IL-17F, IL-21, IL-22, IFN-γ and TNF-α were measured using flow-cytometry.Results: All bacterial cultures were negative, but 29 and eight CSF were positive for bacterial and viral agents by PCR. IL-6, IL-10 and IFN-γ were significantly up-regulated in BM. T helper (Th) subset cytokines showed significant upregulation of Th1, Th2, Th17, Th22 and Tfh cytokines in BM. Common Th subsets cytokines (IL-6, IL-10 and TNF-α) were significantly different between the study groups. ROC curve analysis revealed good AUC for common Th related cytokines in discriminating BM.Conclusions: In pre-treated BM patients with negative bacterial cultures, cytokines IL-6, IL-10 and IFN-γ can predict BM which could be beneficial for rapid diagnosis and treatment to decrease the sequela of the disease.

中文翻译：

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研究脑脊液中T辅助相关细胞因子在儿童儿科患者细菌性脑膜炎的鉴别诊断中的作用。

目的：鉴于细菌性脑膜炎（BM）的诊断挑战，我们评估了抗生素预处理患者脑脊液（CSF）中的不同细胞因子材料和方法：进行了480次实验室测试和聚合酶链反应（PCR）从儿童（2 m至14 y）的脑脊液样本中怀疑脑膜炎，并用抗生素进行预处理，以检测细菌和病毒的病因。包括61个CSF，并检测了13种细胞因子的水平，例如IL-2，IL-4，IL-5，IL-6，IL-9，IL-10，IL-13，IL-17A，IL-17F，结果：所有细菌培养均为阴性，PCR检测29株和8株CSF对细菌和病毒呈阳性。BM中IL-6，IL-10和IFN-γ明显上调。T辅助细胞（Th）亚群的细胞因子显示BM中Th1，Th2，Th17，Th22和Tfh细胞因子显着上调。在研究组之间，常见的Th亚型细胞因子（IL-6，IL-10和TNF-α）显着不同。ROC曲线分析显示，常见的Th相关细胞因子在区分BM中具有良好的AUC。结论：在预处理的BM患者中，细菌培养阴性，细胞因子IL-6，IL-10和IFN-γ可以预测BM，这可能有助于快速诊断和治疗以减少疾病的后遗症。