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However, the metabolic alterations induced by infection remain incompletely understood, and noninvasive monitoring strategies remain urgently needed. In this study, we conducted a systematic metabolomic analysis of two biofluids\u2500cerebrospinal fluid (CSF) and urine\u2500obtained from patients undergoing neurosurgical procedures, using matrix-assisted laser desorption\/ionization mass spectrometry (MALDI-MS). Metabolomic analysis of CSF revealed significant metabolic reprogramming associated with CNS infections, primarily characterized by the dysregulation of energy metabolism, amino acid metabolism, lipid and membrane-related pathways. Interestingly, similar pathway perturbations were also observed in the urinary metabolome. We further observed a significant comprehensive correlation between the urinary and CSF metabolomes. Then, machine learning models were successfully constructed based on urinary metabolomic features for noninvasive disease diagnosis and prognostic evaluation. Both the diagnostic and prognostic models achieved satisfactory classification performance, with area under the receiver operating characteristic curve values greater than 0.9. This work presents a novel, rapid, and noninvasive strategy for the detection and clinical management of CNS infections, which may facilitate timely and accurate clinical intervention and ultimately improve patient outcomes.<\/jats:p>","DOI":"10.1021\/acs.analchem.6c02708","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:38:14Z","timestamp":1788309494000},"page":"26565-26574","source":"Crossref","is-referenced-by-count":0,"title":["Dual-Biofluid\nMetabolomic Profiling by MALDI-MS Enables\nNoninvasive Diagnosis and Prognosis of Central Nervous System Infections"],"prefix":"10.1021","volume":"98","author":[{"given":"Xiaochen","family":"Lu","sequence":"first","affiliation":[{"name":"Chinese Academy of Sciences , ; ,","place":["Beijing, China, 100190"]},{"name":"University of Chinese Academy of Sciences , ,","place":["Beijing, China, 100049"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8750-0563","authenticated-orcid":true,"given":"Jing","family":"Han","sequence":"additional","affiliation":[{"name":"Chinese Academy of Sciences , ; ,","place":["Beijing, China, 100190"]},{"name":"University of Chinese Academy of Sciences , ,","place":["Beijing, China, 100049"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Aviation General Hospital , , ,","place":["Beijing, China, 100012"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengjie","family":"Wang","sequence":"additional","affiliation":[{"name":"Aviation General Hospital , , ,","place":["Beijing, China, 100012"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenkai","family":"Cong","sequence":"additional","affiliation":[{"name":"Aviation General Hospital , , ,","place":["Beijing, China, 100012"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghong","family":"Qi","sequence":"additional","affiliation":[{"name":"Aviation General Hospital , , ,","place":["Beijing, China, 100012"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8514-6348","authenticated-orcid":true,"given":"Zongxiu","family":"Nie","sequence":"additional","affiliation":[{"name":"Chinese Academy of Sciences , ; ,","place":["Beijing, China, 100190"]},{"name":"University of Chinese Academy of Sciences , ,","place":["Beijing, China, 100049"]},{"name":"Hainan University , , , ,","place":["Haikou, Hainan, China, 570228"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"issue":"9","key":"2026091511085736700_cit1","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/j.cmi.2017.05.013","article-title":"Management\nof post-neurosurgical meningitis: narrative review","volume":"23","author":"Hussein","year":"2017","journal-title":"Clin. 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