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D- and L-lactate in rabbit and human bacterial meningitis.

Abstract
Increased total CSF lactate is an important indicator differentiating bacterial from aseptic meningitis. Bacteria can produce D- and L-lactate; mammalian cells produce only L-lactate. We measured D- and L-lactate production of Streptococcus pneumoniae, Staphylococcus aureus, Neisseria meningitidis and Escherichia coli in vitro, of S. pneumoniae and E. coli in rabbit experimental meningitis and of various common pathogens in CSF from patients with bacterial meningitis. Despite marked in vitro production of D-lactate by S. aureus (maximum: 4.59 mmol/l; i.e. 34.9% of total lactate), N. meningitidis (4.62 mmol/l; i.e. 98.1%) and E. coli (3.14 mmol/l; i.e. 97.2%), minimal amounts were measured in human S. aureus (0.38 mmol/l; i.e. 1.3% of total lactate) or N. meningitidis (0.28 mmol/l; i.e. 3.9%) and experimental E. coli meningitis (0.75 mmol/l; i.e. 4.4%). In only 9 of 54 human CSF samples did D-lactate exceed 0.15 mmol/l. S. pneumoniae did not produce significant amounts of D-lactate in vitro (maximum: 0.55 mmol/l; i.e. 2.7% of total lactate), in experimental meningitis (0.18 mmol/l; i.e. 3%) or in human cases of meningitis (0.28 mmol/l; i.e. 1.9%). In conclusion, increased total CSF lactate in meningitis consists mainly of L-lactate and originates predominantly from host cells. CSF D-lactate is of limited diagnostic value.
AuthorsA Wellmer, J Prange, J Gerber, G Zysk, P Lange, U Michel, H Eiffert, R Nau
JournalScandinavian journal of infectious diseases (Scand J Infect Dis) Vol. 33 Issue 12 Pg. 909-13 ( 2001) ISSN: 0036-5548 [Print] England
PMID11868764 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Lactic Acid
  • Ceftriaxone
Topics
  • Animals
  • Bacteria (drug effects, metabolism)
  • Ceftriaxone (pharmacology)
  • Humans
  • Lactic Acid (biosynthesis, cerebrospinal fluid)
  • Meningitis, Bacterial (metabolism)
  • Meningitis, Pneumococcal (metabolism)
  • Rabbits
  • Species Specificity
  • Streptococcus pneumoniae (metabolism)

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