Study on the predictive value of cerebrospinal fluid microRNA-22 and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury

Wei Yong; Zeng Haijuan; Li Rongqiao; Huang Panliu; Luo Liying; Sun Liuzhong

doi:10.3760/j.issn.1673-4777.2025.02.010

Abstract：Objective To analyze the predictive value of cerebrospinal fluid microRNA-22(miR-22)and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury.Methods The clinical data of 124 patients with traumatic brain injury admitted to Jiangbin Hospital of Guangxi Zhuang Autonomous Region from October 2021 to October 2023 were retrospectively analyzed.The patients were divided into two groups according to whether they had secondary intracranial bacterial infection,50 patients with secondary intracranial bacterial infection were set as the infection group,and 74 patients without intracranial bacterial infection were set as the non-infection group.The levels of cerebrospinal fluid miR-22 and procalcitonin were compared between the two groups.Logistic regression was used to analyze the risk factors of secondary intracranial bacterial infection in patients with traumatic brain injury.The receiver operating characteristic curve was drawn to analyze the predictive efficacy of cerebrospinal fluid miR-22 and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury.Results The levels of miR-22 and procalcitonin in cerebrospinal fluid of infection group were higher than those of non-infection group[(3.61±0.51)vs(0.64±0.13),(3.36±0.62)μg/L vs(0.89±0.13)μg/L](t=47.929,33.266,both P＜0.001).Logistic regression analysis showed that cerebro-spinal fluid miR-22,cerebrospinal fluid procalcitonin,preoperative neutrophil to lymphocyte ratio,postoperative intracranial gas,postoperative cerebrospinal fluid leakage and drainage tube time were risk factors for secondary intracranial bacterial infection in patients with traumatic brain injury(all P＜0.05).The area under the curve of combination of cerebrospinal fluid miR-22 and procalcitonin in predicting secondary intracranial bacterial infection in patients with traumatic brain injury was 0.859,and 95％confidence interval was 0.806 to 0.944.The area under the curve of combination of cerebrospinal fluid miR-22 and procalcitonin in predicting secondary intracranial bacterial infection in patients with traumatic brain injury was larger than that of single detection(Z=2.913,P=0.006;Z=2.458,P=0.012).Conclusion The increase of cerebrospinal fluid miR-22 and procalcitonin is closely related to secondary intracranial bacterial infection in patients with traumatic brain injury.Combined detec-tion of cerebrospinal fluid miR-22 and procalcitonin can improve the prediction efficiency of secondary intracranial bacterial infection,and may become a new index to evaluate the condition of patients with traumatic brain injury.