Analysis of Cerebrospinal Fluid in Diagnosis of Bacterial Meningitis; Using Nuclear Magnetic Resonance Spectroscopy: A Systematic Review

Background: Analysis of biofluids provides a unique window into the biochemical status of a living organism since the composition of a given biofluid will be modulated according to the level of function of the cells that are intimately concerned with its manufacture and secretion. One of the most successful approaches to biofluid analysis has been the application of NMR spectroscopy. Objectives: The aim of this study was the survey of the role of Nuclear Magnetic Resonance (NMR) Spectroscopy in differential diagnosis of septic bacterial meningitis. Methods: Using the search strategy from three databases (MEDLINE/PMC, Web of Science, Scopus), list of references of selected articles and gray literature, without time and language limitation, articles up to March 2017 were entered into this review. In this review, 219 articles were acquired at the primary search. Study selection and quality assessment processes were done based on Cochrane library guidelines. After assessing the quality and inclusion and exclusion criteria, 4 articles were selected and entered into the data synthesis. Results: The results of 4 studies demonstrated relative elevation of lactate value and extracellular acidosis in bacterial meningitis not in aseptic meningitis. Moreover in most of them, decreasing its level by treatment was evident. Conclusion: Metabolomic analysis with NMR spectroscopy of cerebrospinal fluid can become a powerful helping in differentiation of septic meningitis from aseptic meningitis.