{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T08:00:57Z","timestamp":1773820857835,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early identification of high-risk patients is crucial for improving outcomes of bacterial meningitis (BM) patients. The blood urea nitrogen to albumin (BUN\/ALB) ratio has demonstrated prognostic value in various critical illnesses, but its role in BM remains unestablished.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 146 adult patients with microbiologically confirmed BM hospitalized between 2010 and 2025. BUN\/ALB ratio within 6 hours of admission was calculated. Based on 3-month post-discharge modified Rankin Scale (mRS) scores, patients were dichotomized into favorable (mRS 0\u20132) and unfavorable (mRS 3\u20136) prognostic groups. Multivariable logistic regression was used to examine the association between BUN\/ALB ratio and unfavorable outcome, adjusting for relevant confounders. The predictive performance was assessed using receiver operating characteristic curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among included patients, 87 (59.6%) had unfavorable outcomes. The unfavorable prognosis group exhibited significantly higher admission BUN\/ALB ratios compared to the favorable group (5.23 vs. 2.86,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). After adjustment for age, gender, diabetes history, headache, neurological deficits, pathogen type, and mechanical ventilation, patients in the highest BUN\/ALB tertile (&amp;gt; 5.13) showed a 20-fold increased risk of unfavorable outcome compared to the lowest tertile (adjusted OR = 20.494,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). A significant dose-response relationship was observed (\n                      <jats:italic>P<\/jats:italic>\n                      for trend &amp;lt;0.001). RCS analysis supported a linear association (\n                      <jats:italic>P<\/jats:italic>\n                      for no-linearity=0.1503). The BUN\/ALB ratio demonstrated discriminative ability with an area under the curve of 0.8.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Admission BUN\/ALB ratio independently predicts 3-month unfavorable neurological outcomes in BM patients. This routinely available, low-cost biomarker may serve as a practical tool for early risk stratification and could guide more intensive monitoring and intervention in high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1781379","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:00:00Z","timestamp":1773817200000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of the blood urea nitrogen to serum albumin ratio on prognosis in patients with bacterial meningitis: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Anxin","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Neurology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaoyao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaona","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kejian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Physics, School of Basic Medicine, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.3390\/ijms26041427","article-title":"Investigating blood biomarkers that can facilitate the diagnosis of meningitis-A systematic literature review","volume":"26","author":"Baran","year":"2025","journal-title":"Int. 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