Cerebrospinal fluid glucose-to-lactate ratio (CGLR) as a diagnostic biomarker for postoperative intracranial infections in patients with acute brain injury: a prospective diagnostic accuracy study - Report - MDSpire

Cerebrospinal fluid glucose-to-lactate ratio (CGLR) as a diagnostic biomarker for postoperative intracranial infections in patients with acute brain injury: a prospective diagnostic accuracy study

  • By

  • Weidong Wang

  • Huajun Wang

  • Chengjie Zhou

  • Ye Fu

  • June 10, 2026

  • 0 min

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Clinical Report: Evaluating the Diagnostic Utility of Cerebrospinal Fluid Glucose-to-Lactate Ratio

Overview

This study assesses the cerebrospinal fluid glucose-to-lactate ratio (CGLR) as a diagnostic tool for postoperative intracranial infections in acute brain injury patients. CGLR demonstrated superior diagnostic performance compared to traditional biomarkers.

Background

Postoperative intracranial infections pose significant risks in patients with acute brain injury (ABI), leading to increased mortality and morbidity. Early and accurate diagnosis is crucial for timely intervention. Traditional diagnostic methods, such as CSF culture, have limitations, highlighting the need for reliable biomarkers like CGLR.

Data Highlights

BiomarkerAUCOptimal Cutoff
CSF Glucose (cGlu)0.8362.6 mmol⋅L–1
CSF Lactate (cLac)0.8204.5 mmol⋅L–1
CGLR0.8660.61

Key Findings

  • CGLR outperformed traditional biomarkers with an AUC of 0.866.
  • Optimal cutoff for CGLR was determined to be 0.61.
  • CSF glucose and lactate showed AUC values of 0.836 and 0.820, respectively.
  • CGLR values were consistent across different patient cohorts (SAH, ICH, TBI).
  • CGLR remained unaffected by peripheral glucose levels in patients.

Clinical Implications

CGLR can serve as a rapid and cost-effective biomarker for diagnosing postoperative intracranial infections, potentially improving patient outcomes. Its reliability across various patient cohorts makes it a valuable tool in clinical practice.

Conclusion

CGLR is a promising diagnostic marker for postoperative intracranial infections in ABI patients, offering advantages over traditional methods. Its implementation could enhance early detection and treatment strategies.

Related Resources & Content

  1. Conexiant, Conexiant, 2023 -- Lactate–Albumin Ratio Tied to TBI Mortality
  2. Assessment of Granulocyte Presence in Cerebrospinal Fluid Among Adults with Suspected Central Nervous System Infections: A Prospective Evaluation of Diagnostic Precision
  3. Evaluating the Role of (1,3)-β-D-glucan in Diagnosing Invasive Candidiasis Among ICU Patients: A Prospective Cohort Analysis
  4. IDSA 2017 Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis
  5. Infections Related to Ventriculostomy in Acute Brain Injury Patients: A Retrospective Analysis
  6. Current guidance on postoperative meningitis/ventriculitis
  7. Evidence review for investigating and diagnosing suspected bacterial meningitis
  8. A systematic review of reviews on ventriculostomy related infection definitions: A fundamental problem - PubMed
  9. Ventriculitis: A Retrospective Cohort Study of Clinical Features, Outcomes and Device Management Practices | Open Forum Infectious Diseases | Oxford Academic
  10. Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections | Clinical Microbiology Reviews
  11. The diagnostic value of cerebrospinal fluid lactate for post-neurosurgical bacterial meningitis: a meta-analysis - PMC
  12. The value of elevated cerebrospinal fluid lactate concentrations in post-neurosurgical bacterial meningitis - PMC
  13. Combined Lactate Glucose Ratio as a Novel Marker for Rapid Diagnosis of Cerebrospinal Fluid Bacterial Infection in Neurosurgical Patients: Diagnostic Accuracy Study and Benchtop Analyzer Correlation - ScienceDirect
  14. Development and validation of a diagnostic nomogram for post-neurosurgical bacterial meningitis | BMC Neurology | Springer Nature Link
  15. Cerebrospinal Fluid Metabolome in Central Nervous System Infections: A Study of Diagnostic Accuracy - Staal - 2025 - Annals of Neurology - Wiley Online Library

Original Source(s)

Cerebrospinal fluid glucose-to-lactate ratio (CGLR) as a diagnostic biomarker for postoperative intracranial infections in patients with acute brain injury: a prospective diagnostic accuracy study

  • by Weidong Wang, Huajun Wang, Chengjie Zhou, Ye Fu

  • June 10, 2026

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