OBJECTIVE To explore the differential value of soluble interleukin-2 receptor (SIL-2R), vascular endothelial cell calcium binding protein(VE-cadherin) and β2-microglobulin (β2-MG) expression levels in cerebrospinal fluid for identifying pathogenic microorganisms in children with central nervous system infections (ICNS).

METHODS One hundred and twenty-three children with ICNS who received treatment in Children′s Hospital Affiliated to Jiangnan University from Jan. 2021 to Dec. 2023 were selected as the group A and divided into the virus meningitis (VM) group with 78 cases and the bacterial meningitis (BM) group with 45 cases according to the types of pathogens. Another 135 patients who were suspected intracranial infections and extracted cerebrospinal fluid and excluded CNS lesions were selected during the same period as group B. The levels of SIL-2R, VE-cadherin and β2-MG in cerebrospinal fluid of the two groups and among different types of pathogenic microorganisms were compared. Under the premise of BM positive and VM negative, receiver operating characteristic (ROC) curve analysis was used to investigate the discrimination performance of cerebrospinal fluid SIL-2R, VE-cadherin and β2-MG for pathogenic microorganisms in children with CNS infections.

RESULTS The levels of SIL-2R, VE cadherin, and β2-MG in the cerebrospinal fluid of the group A were (156.88±11.54) U/ml, (6.82±1.93) mg/L, and (5.92±1.24) mg/L, respectively, while those in the group B were (90.54±6.65)U/ml, (1.87±0.58) mg/L, and (1.54±0.54) mg/L. There was a statistically significant difference in the levels of SIL-2R, VE cadherin, andβ2-MG in the cerebrospinal fluid between the two groups (P < 0.05) The levels of SIL-2R, VE cadherin, and β 2-MG in the cerebrospinal fluid of the BM group were (187.65±13.43) U/ml, (8.43±2.51) mg/L, and (8.01±1.54) mg/L, respectively, while those in the VM group were (137.54±10.43) U/ml, (5.87±1.65) mg/L, and (4.65±1.12) mg/L. There was a statistically significant difference in the levels of SIL-2R, VE cadherin, and β 2-MG in the cerebrospinal fluid between the two groups (P < 0.05) BM was included as positive and VM as negative. The area under the curve (AUC) for cerebrospinal fluid SIL-2R, VE-cadherin, β2-MG and combined detection to identify pathogenic microorganisms types in children with ICNS were 0.695, 0.641, 0.650 and 0.902, respectively. The sensitivity were 66.67%, 64.44%, 66.67%, 86.67%, and the specificity were 67.95%, 67.95%, 65.38%, 91.03%, respectively, among which the AUC of combined detection was the highest (P < 0.05).

CONCLUSIONS Cerebrospinal fluid SIL-2R, VE-cadherin and β2-MG are closely related to the occurrence of CNS infections and the types of pathogenic microorganisms. They also have high application values in the discrimination of BM and VM, especially when combined with the highest value.