Investigating the Diagnostic Significance of Neutrophil Percentage to Albumin Ratio (NPAR) in Patients with Infectious Meningitis
DOI:
https://doi.org/10.61919/jhrr.v4i2.969Keywords:
Diagnostics, Infection, Inflammation, Meningitis, NPARAbstract
Background: Meningitis, characterized by inflammation of the meninges, typically presents with fever, headache, and neck rigidity. Despite the availability of numerous diagnostic techniques, determining the etiology of infectious meningitis remains challenging, often leading to diagnostic delays and increased mortality. The neutrophil percentage-to-albumin ratio (NPAR) is a novel biomarker for systemic infection and inflammation.
Objective: To assess the neutrophil-to-albumin ratio in cases of infectious meningitis.
Methods: Following REC approval (05/01/REC-206-2020), this cross-sectional study included 78 patients with clinical findings consistent with meningitis. Data on age, gender, fever, headache, neck rigidity, and Glasgow Coma Scale (GCS) were collected. NPAR was calculated by dividing the neutrophil percentage by serum albumin levels. Statistical analysis was performed using SPSS 22.0 for T-test (two-tailed) and Pearson Correlation. Results were presented as mean±SD (95% CI) with a significance level of p<0.05.
Results: The mean age of patients was 27 years. The mean GCS score was 11±1.59, serum albumin levels were 3.44±0.5 mg/dl, neutrophil percentage was 75.6±7.2%, and the neutrophil-to-albumin ratio (NPAR) was 0.22±0.03. Common symptoms such as fever, neck rigidity, and headache were present in all cases, while seizures were observed in 36 cases.
Conclusion: The study indicated a significant correlation between elevated NPAR levels and cases of infectious meningitis, suggesting NPAR as a potential diagnostic marker.
Downloads
References
Barichello T, Rocha Catalão CH, Rohlwink UK, Kuip MV, Zaharie D, Solomons RS, et al. Bacterial meningitis in Africa. Front Neurol. 2023 Feb 14;14:822575 doi: 10.3389/fneur.2023.822575
Yekani M, Memar MY. Immunologic biomarkers for bacterial meningitis. Clin Chim Acta. 2023 Jul 5:117470. doi: 10.1016/j.cca.2023.117470
Julián-Jiménez A, Morales-Casado MI. Usefulness of blood and cerebrospinal fluid laboratory testing to predict bacterial meningitis in the emergency department. Neurología (English Edition). 2019 Mar 1;34(2):105-13. doi: 10.1016/j.nrl.2016.05.009
Brouwer MC, Tunkel AR, van de Beek D. Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. Clin Microbiol Rev. 2022 Jul 13;35(3):e00157-21. DOI: 10.1128/CMR.00157-21.
Kim KS. Acute bacterial meningitis in infants and children. Lancet Infect Dis. 2022 Apr;22(4):e87-98.
van de Beek D, Cabellos C, Dzupova O, Esposito S, Klein M, Kloek AT, et al. ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clin Microbiol Infect. 2021 May;27(5):553-66.
McIntyre PB, O'Brien KL, Greenwood B, van de Beek D. Effect of vaccines on bacterial meningitis worldwide. Lancet. 2022 Jan 8;399(10319):47-55.
Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, et al. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2021 May 5;364(21):2016-25.
van de Beek D, Brouwer M, Hasbun R, Koedel U, Whitney CG, Wijdicks E. Community-acquired bacterial meningitis. Nat Rev Dis Primers. 2021 Dec;7(1):30.
Castagno E, Aguzzi S, Rossi L, Gallo R, Carpino A, Ricceri F, et al. Clinical predictors and biomarkers in children with sepsis and bacterial meningitis. Pediatr Emerg Care. 2023 May 1;39(5):311-7. DOI: 10.1097/PEC.0000000000002865
Pan J, Xu W, Song W, Zhang T. Bacterial meningitis in children with an abnormal craniocerebral structure. Front Pediatr. 2023 Mar 28;11:997163.doi: 10.3389/fped.2023.997163
Davis LE. Acute bacterial meningitis. Continuum (Minneap Minn). 2018 Oct;24(5):1264-83.
Zhang R, Zhang Y, Liu Z, Pei Y, He Y, Yu J, et al. Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage. BMC Neurol. 2023 Oct 19;23(1):374.
Bystritsky RJ, Chow FC. Infectious meningitis and encephalitis. Neurol Clin. 2022 Feb;40(1):77-91. doi: 10.1016/j.ncl.2021.08.006
He X, Dai F, Zhang X, Pan J. The neutrophil percentage‐to‐albumin ratio is related to the occurrence of diabetic retinopathy. J Clin Lab Anal. 2022 Apr;36(4):e24334. doi: 10.1002/jcla.24334
Aimbudlop K, Bruminhent J, Kiertiburanakul S. Infectious causes of acute meningitis among Thai adults in a university hospital. J Infect Chemother. 2021 Feb 1;27(2):198-204. doi: 10.1016/j.jiac.2020.09.002
Lundbo LF, Benfield T. Risk factors for community-acquired bacterial meningitis. Infect Dis (Lond). 2017 Jun 3;49(6):433-44.doi: 10.1080/23744235.2017.1285046
Adriani KS, Brouwer MC, van de Beek D. Risk factors for community-acquired bacterial meningitis in adults. Neth J Med. 2015;73(2):53-60.
Strunk JA, Rocchiccioli JT. Meningococcal meningitis: an emerging infectious disease. J Community Health Nurs. 2010 Jan 27;27(1):51-.doi: 10.1080/07370010903466197
Hlebowicz M, Jakubowski P, Smiatacz T. Streptococcus suis meningitis: epidemiology, clinical presentation and treatment. Vector Borne Zoonotic Dis. 2019 Aug 1;19(8):557-62.
Shi Y, Chen J, Shi X, Hu J, Li H, Li X, et al. A case of chlamydia psittaci caused severe pneumonia and meningitis diagnosed by metagenome next-generation sequencing and clinical analysis: a case report and literature review. BMC Infect Dis. 2021 Jun 30;21(1):621.doi: 10.1186/s12879-021-06205-5
Bagheri-Nesami M, Babamahmoodi F, Nikkhah A. Types, risk factors, clinical symptoms and diagnostic tests of acute adult meningitis in northern Iran during 2006-2012. J Clin Diagn Res. 2015 May;9(5):IC01.
Liu CF, Chien LW. Predictive role of neutrophil-percentage-to-albumin ratio (NPAR) in nonalcoholic fatty liver disease and advanced liver fibrosis in nondiabetic US adults: evidence from NHANES 2017–2018. Nutrients. 2023 Apr 14;15(8):1892. doi: 10.3390/nu15081892
Lv XN, Shen YQ, Wang ZJ, Hu X, Pu MJ, Li Q. Neutrophil percentage to albumin ratio is associated with stroke-associated pneumonia and poor outcome in patients with spontaneous intracerebral hemorrhage. Front Immunol. 2023 Jun 14;14:1173718. doi: 10.3389/fimmu.2023.1173718.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Rabia Bughio, Khalida Depar, Amber Ghani, Fida Depar, Etizaz Ahmed , Atif Depar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Public Licensing Terms
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license:
- You are free to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) for any purpose, including commercial use.
- Attribution must be given to the original author(s) and source in a manner that is reasonable and does not imply endorsement.
- No additional restrictions may be applied that conflict with the terms of this license.
For more details, visit: https://creativecommons.org/licenses/by/4.0/.
