Diagnostic value of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 for intracranial infection after neurosurgery

OBJECTIVE  To investigate the levels of plasma exosome hsa-miR-4725-3p, serum glial fibrillary acidic protein (GFAP) and serum ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), as well as their diagnostic value for intracranial infection after neurosurgery.

METHODS  A total of 43 patients with intracranial infection after neurosurgery who were admitted to the Department of Neurosurgery of the Affiliated Hospital of Guizhou Medical University from Jan. 2021 to Dec. 2023 were selected as the case group, while 129 gender- and age-matched patients (no infection∶case=3∶1) without intracranial infection after neurosurgery who were admitted during the same period served as the no infection group. The distribution of pathogenic bacteria in the two groups was analyzed. The levels of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 were measured and compared between the two groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of these indicators for intracranial infection after neurosurgery.

RESULTS  A total of 46 pathogenic bacteria were isolated from cerebrospinal fluid samples of 43 patients with postoperative intracranial infection, including 30 gram-negative bacteria (65.22%), predominantly Klebsiella pneumoniae, 15 gram-positive bacteria (32.61%), predominantly Staphylococcus aureus and one fungus (2.17%). The levels of plasma hsa-miR-4725-3p, serum GFAP and UCH-L1 in the intracranial infection group were 2.05±0.35, (0.58±0.14) ng/ml and (0.78±0.18) ng/ml, respectively, all higher than those in the no infection group (P＜0.05). The area under the curve (AUC) (0.825) for the combined detection of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 in diagnosing postoperative intracranial infection was higher than that of individual detection (P＜0.05).

CONCLUSIONS  The detection of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 levels is helpful for the diagnosis of intracranial infection after neurosurgery, and combined detection can improve diagnostic efficacy.