{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:01:44Z","timestamp":1780131704115,"version":"3.54.0"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Microbiological analysis might not be able to identify the causative pathogen in one-third of brain abscess patients. Proteomics analysis of brain abscesses can aid in microbiological diagnosis. This could help tailor the antimicrobial therapy, give possible insights into the source of the abscess, and aid in developing targeted antimicrobial agents.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This was a single-center prospective study including patients with brain abscess recruited over a 1-year period. Proteome-based analysis was used to identify the causative pathogen, and the results were compared using conventional microbiological analysis. The involved host proteins were identified and correlated with the abscess volume.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Thirty-four patients with brain abscesses were included. The mean volume of the abscess was 30.4 cm\n 3<\/jats:sup>\n . A pus sample was obtained by craniotomy excision (67.6% of cases), burr hole aspiration (17.6% of cases), or twist-drill craniostomy aspiration (14.7% of cases). Proteomics analysis was successful in 19 (55.9%) samples. The remaining samples were rejected during preprocessing due to technical\/sampling issues. In total, 7331 proteins were identified from 19 samples, with a mean of 385 proteins (range 291\u2013615 proteins) per sample. All patients except one were found to have polymicrobial infection based on proteomics analysis, with a median of 4 microorganisms per sample. The causative pathogen could be identified by microbiological analysis in 25 of 34 (73.5%) patients and in 15 of 19 (78.9%) patients with successful proteomics analysis.\n Staphylococcus aureus, Acinetobacter baumannii<\/jats:italic>\n , and\n Escherichia coli<\/jats:italic>\n were the most common microorganisms on proteomics analysis, whereas\n Streptococcus intermedius, Streptococcus constellatus<\/jats:italic>\n , and\n S. aureus<\/jats:italic>\n were the most common microorganisms on microbiological analysis. Microorganisms identified by microbiological analysis matched one of the results from proteomics analysis in 66.7% of patients. Of the inflammatory proteins identified, ferritin heavy chain, neutrophil collagenase isoform XI, proteasome subunit beta type-1, ferritin light chain isoform XI, proteasome subunit alpha type-6 isoform a, resistin precursor, and neutrophil defensin 1 isoform XI showed a positive correlation with abscess volume, whereas complement C3 preproprotein, serotransferrin isoform 1, and histone H2B type 1-D protein showed a negative correlation.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Proteomics analysis suggests that most brain abscesses contain polymicrobial colonization, which underscores the importance of broad-spectrum antibiotics in their treatment. It can aid in diagnosis when conventional tests fail to isolate the pathogen and can provide deeper insights into microorganism-host interactions.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.8.focus25612","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T12:05:40Z","timestamp":1761998740000},"page":"E12","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced microbiological evaluation of brain abscesses by proteomics-based techniques: a prospective cohort study"],"prefix":"10.3171","volume":"59","author":[{"given":"Nisarg","family":"Parmar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kautilya R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhusudhan","family":"Nagesh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagarathna","family":"Chandrashekar","sequence":"additional","affiliation":[{"name":"Department of Neuromicrobiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gajanan","family":"Sathe","sequence":"additional","affiliation":[{"name":"Center for Molecular Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandeesh B.","family":"Nanjegowda","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhuraj","family":"Andiperumal Raj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"N Engl J Med","first-page":"447","article-title":"Brain abscess","volume":"371","author":"Brouwer MC","year":"2014","unstructured":"Brouwer MC, Tunkel AR, McKhann GM II, van de Beek D. Brain abscess. N Engl J Med. 2014;371(5):447\u2013456."},{"issue":"9","key":"b2","series-title":"Neurology","first-page":"806","article-title":"Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis","volume":"82","author":"Brouwer MC","year":"2014","unstructured":"Brouwer MC, Coutinho JM, van de Beek D. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology. 2014;82(9):806\u2013813."},{"issue":"2","key":"b3","series-title":"J Chromatogr Sci","first-page":"182","article-title":"Proteomics: technologies and their applications","volume":"55","author":"Aslam B","year":"2017","unstructured":"Aslam B, Basit M, Nisar MA, Khurshid M, Rasool MH. Proteomics: technologies and their applications. J Chromatogr Sci. 2017;55(2):182\u2013196."},{"key":"b4","series-title":"Infect Drug Resist","first-page":"1785","article-title":"Proteomic applications in antimicrobial resistance and clinical microbiology studies","volume":"13","author":"Khodadadi E","year":"2020","unstructured":"Khodadadi E, Zeinalzadeh E, Taghizadeh S, Proteomic applications in antimicrobial resistance and clinical microbiology studies. Infect Drug Resist. 2020;13:1785\u20131806."},{"issue":"3","key":"b5","series-title":"J Neurosurg","first-page":"829","article-title":"The proteome of pus from human brain abscesses: host-derived neurotoxic proteins and the cell-type diversity of CNS pus","volume":"129","author":"Hassel B","year":"2018","unstructured":"Hassel B, Souza GAD, Stensland ME, Ivanovic J, Voie \u00d8, Dahlberg D. The proteome of pus from human brain abscesses: host-derived neurotoxic proteins and the cell-type diversity of CNS pus. 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