OBJECTIVES Central nervous system (CNS) infections account for considerable death and disability every year. An urgent research priority is scaling up diagnostic capacity, and introduction of point-of-care tests. We set out to assess current evidence for the application of mass spectrometry (MS) peptide sequencing in identification of diagnostic biomarkers for CNS infections. METHODS We performed a systematic review (PROSPEROCRD42018104257) using PRISMA guidelines on use of MS to identify cerebrospinal fluid (CSF) biomarkers for diagnosing CNS infections. We searched PubMed, Embase, Web of Science, and Cochrane for articles published from 1 January 2000 to 1 February 2019, and contacted experts. Inclusion criteria involved primary research except case reports, on the diagnosis of infectious diseases except HIV, applying MS to human CSF samples, and English language. RESULTS 4,620 papers were identified, of which 11 were included, largely confined to pre-clinical biomarker discovery, and eight (73%) published in the last five years. 6 studies performed further work termed verification or validation. In 2 of these studies, it was possible to extract data on sensitivity and specificity of the biomarkers detected by ELISA, ranging from 89-94% and 58-92% respectively. CONCLUSIONS The findings demonstrate feasibility and potential of the methods in a variety of infectious diseases, but emphasise the need for strong interdisciplinary collaborations to ensure appropriate study design and biomarker validation.

中文翻译：

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基于质谱的蛋白质组学技术，用于识别脑脊液生物标志物，以诊断疑似中枢神经系统感染。系统回顾。

目标 中枢神经系统 (CNS) 感染每年造成大量死亡和残疾。一项紧迫的研究重点是扩大诊断能力并引入即时检测。我们着手评估质谱 (MS) 肽测序在鉴定中枢神经系统感染诊断生物标志物中应用的现有证据。方法 我们使用 PRISMA 指南对使用 MS 识别脑脊液 (CSF) 生物标志物以诊断 CNS 感染进行了系统评价 (PROSPEROCRD42018104257)。我们检索了 PubMed、Embase、Web of Science 和 Cochrane 2000 年 1 月 1 日至 2019 年 2 月 1 日发表的文章，并联系了专家。纳入标准涉及除病例报告外的初步研究、除 HIV 外的传染病诊断、对人类脑脊液样本应用 MS 以及英语。结果 共确定了 4,620 篇论文，其中 11 篇被纳入，主要限于临床前生物标志物的发现，其中 8 篇 (73%) 是在过去五年中发表的。6 项研究进行了称为验证或确认的进一步工作。在其中 2 项研究中，可以提取 ELISA 检测的生物标志物的敏感性和特异性数据，范围分别为 89-94% 和 58-92%。结论 研究结果证明了该方法在多种传染病中的可行性和潜力，但强调需要强有力的跨学科合作，以确保适当的研究设计和生物标志物验证。