Urgent need for screening of peripheral blood-based immunologic biomarkers for the diagnosis of bacterial meningitis

Bacterial meningitis (BM) is a medical emergency requiring immediate intervention. Despite significant progress in prevention and treatment, the rapid and accurate diagnosis of BM remains a global challenge. The clinical symptoms of bacterial and aseptic meningitis often overlap, and while cerebrospinal fluid (CSF) analysis and microbial culture are commonly used for differentiation, lumbar puncture is not always feasible in patients with contraindications or uncertain clinical conditions. Consequently, the identification of biomarkers from blood samples has become a critical focus. Analysis of the host immune response to pathogens offers the potential for early detection of the disease before the manifestation of clinical symptoms. Advances in bioinformatics and genetic technologies have facilitated their application to the diagnosis of various diseases. This review summarizes the limitations of current BM diagnostic methods and underscores the urgent need to adopt innovative approaches, such as leveraging peripheral blood immune response signatures through multi-omics and genetic methodologies, to identify diagnostic targets. Implementing these strategies is crucial for enhancing the timeliness of BM diagnosis, improving treatment effectiveness, and ultimately advancing patient outcomes.