STUDY OF THE SPECTRUM OF MICRORGANISMS, THEIR ANTIBACTERIAL SENSITIVITY AND DETERMINATION OF THE CLINICAL VALUE OF CEREBROSPINAL FLUID INTERLEUKIN-6 AND PRESEPSIN QUANTITATION IN PATIENTS WITH MENINGOENCEPHALITIS AFTER NEUROSURGICAL HEAD INJURY



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Abstract

Neuroinflammation is a most severe head trauma complication, so that assessing a relation between cerebrospinal fluid (CSF) markers and bacterial infection becomes a pressing issue. The study was aimed at analyzing etiologic pattern and evaluate clinical utility of CSF inflammatory markers in patients with meningoencephalitis after neurosurgical head injury (NHI), admitted to the Reanimation unit at the Burdenko Main Military Clinical Hospital in 2023–2024. Two groups were formed: first group (1G) included 23 patients with meningoencephalitis after NHI and negative CSF cultures, second group (2G) included 32 patients with  meningoencephalitis after NHI and positive CSF cultures. The control group (CG) consisted of 12 trauma patients with no signs of CNS infection. Spectrum of microorganisms in the CSF and median levels of leukocytes, protein, cytosis, IL-6, and  presepsin (PSP) were studied. Threshold levels for cytosis, IL-6, and PSP were calculated while comparing these groups. The results of the analysis on CSF microbial spectrum in 2G patients indicate infection with clinically significant (mainly K. pneumoniae, A. baumannii and coagulase-negative staphylococci (CoNS)) flora. Significant differences in the CSF of patients in 1G and 2G compared to the CG were obtained in the number of leukocytes, protein, cytosis, IL-6, and PSP. The threshold of clinical decision of parameters in CSF in the 1G in relation to the CG: for cytosis - 69 cells / mcl, for IL-6 - 587.1 pg / ml, for the PSP  - 546.0 pg / ml. Reliable differences in CSF in patients of the 1G and 2G between the values ​​​​of cytosis, IL-6, PSP were established. Threshold values ​​​​are proposed for the 2G vs. CG and for the 2G vs. 1G: cytosis - 1546.0 and 826.6 cells / mcl, IL-6 levels - 4241.5 and 3672.5 pg / ml, PSP - 1027.5 and 1219.0 pg / ml, respectively. Reliable threshold  values for IL-6 and PSP in CSF were obtained, which can be used as additional markers for diagnosis of bacterial complications in patients with meningoencephalitis after NHI.

About the authors

Olga Tkachenko

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation

Email: otkachenko84@mail.ru
ORCID iD: 0009-0003-4294-5037

doctor of the highest category, Chief of laboratory clinical microbiology the Department Microbiology Research of the Center for Clinical Laboratory Diagnostics

Russian Federation, 105094, Russian Federation, Moscow, Hospitalnaya sq. 3

Nikolay Borisovich Esaulenko

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation

Email: back.lab@yandex.ru
ORCID iD: 0000-0002-3514-6814

M.D., doctor of the highest category, Department Head of Microbiology Center for Clinical Laboratory Diagnostics of the Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense 

Russian Federation, 105094, Russian Federation, Moscow, Hospitalnaya sq. 3

Sergey Petrovich Kazakov

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation;
Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russian Federation;
Russian Association of Medical Laboratory Diagnostics, Moscow, Russian Federation

Email: gvkg.ckld@mail.ru
ORCID iD: 0000-0001-6528-1059
Scopus Author ID: 57211351588
ResearcherId: C‑6644–2018

Head of Сenter for Clinical Laboratory Diagnostics;Ph.D, associate Professor (Docent), Professor of the Department of Clinical Laboratory Diagnostics, Medical Microbiology and Pathological Anatomy;Рresident of Russian Association of Medical Laboratory Diagnostics.

Russian Federation

Marina Victorovna Nesterova

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation

Email: nestmv@yandex.ru
ORCID iD: 0009-0007-1385-3618

MD, PhD, Chief of laboratory of sanitary and bacteriological research оf the Department Microbiology Research of the Center for Clinical Laboratory Diagnostics 

Russian Federation

Tatyana Evgenievna Mishina

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation

Email: Yrjh@yandex.ru
ORCID iD: 0009-0006-9168-6045

MD, doctor of clinical laboratory diagnostics of the Department of Clinical Infectious and Immunological Research of the Center for Clinical Laboratory Diagnostics of the Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russia

Russian Federation

Denis Vladimirovich Davydov

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation

Email: hospitalburdenko@inbox.ru
ORCID iD: 0000-0001-5449-9394

MD, ScD, Professor, Chief 

Russian Federation

Shamil Khambalovich Gizatullin

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation;
Federal State Budget Founding BIOTECH University, Medical Institute of Continuing Education, Moscow, Russian Federation

Email: gizat_sha@mail.ru
ORCID iD: 0000-0002-2953-9902
Scopus Author ID: 6603402209

Head of the Neurosurgical Center, is Chief Neurosurgeon 

Russian Federation

Andrey Alekseevich Zaytsev

Main Military Clinical Hospital named after academician N.N. Burdenko Russian Defense Ministry, Moscow, Russian Federation;
Federal State Budget Founding BIOTECH University, Medical Institute of Continuing Education, Moscow, Russian Federation;
Russian University of Medicine of Ministry of Health of the Russian Federation, Moscow, Russian Federation

Email: a-zaicev-a@yandex.ru
ORCID iD: 0000-0002-0934-7313

MD, ScD, Professor, chief pulmonologist 

Russian Federation

Marina Yurievna Chernukha

Gamaleya National Research Center for Epidemiology and Microbiology, Moscow, Russian Federation

Author for correspondence.
Email: chernukha08@mail.ru

MD, ScD, Head of the Laboratory of Epidemiology of Nosocomial Infections, Federal Government Budgetary Institution «National Research Center for Epidemiology and Microbiology named after Honorary Academician N.F. Gamaleya of the Ministry of Health of the Russian Federation»; Moscow, Russia

Russian Federation

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