{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T20:13:46Z","timestamp":1792959226904,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,3,28]],"date-time":"2021-03-28T00:00:00Z","timestamp":1616889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["PGC2018-096956-B-C43"],"award-info":[{"award-number":["PGC2018-096956-B-C43"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Differential diagnosis between bacterial and viral meningitis is crucial. In our study, to differentiate bacterial vs. viral meningitis, three machine learning (ML) algorithms (multiple logistic regression (MLR), random forest (RF), and na\u00efve-Bayes (NB)) were applied for the two age groups (0\u201314 and &gt;14 years) of patients with meningitis by both conventional (culture) and molecular (PCR) methods. Cerebrospinal fluid (CSF) neutrophils, CSF lymphocytes, neutrophil-to-lymphocyte ratio (NLR), blood albumin, blood C-reactive protein (CRP), glucose, blood soluble urokinase-type plasminogen activator receptor (suPAR), and CSF lymphocytes-to-blood CRP ratio (LCR) were used as predictors for the ML algorithms. The performance of the ML algorithms was evaluated through a cross-validation procedure, and optimal predictions of the type of meningitis were above 95% for viral and 78% for bacterial meningitis. Overall, MLR and RF yielded the best performance when using CSF neutrophils, CSF lymphocytes, NLR, albumin, glucose, gender, and CRP. Also, our results reconfirm the high diagnostic accuracy of NLR in the differential diagnosis between bacterial and viral meningitis.<\/jats:p>","DOI":"10.3390\/diagnostics11040602","type":"journal-article","created":{"date-parts":[[2021,3,28]],"date-time":"2021-03-28T22:09:01Z","timestamp":1616969341000},"page":"602","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Artificial Intelligence in Differential Diagnostics of Meningitis: A Nationwide Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1480-390X","authenticated-orcid":false,"given":"Alexios-Fotios A.","family":"Mentis","sequence":"first","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 122 43 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4935-438X","authenticated-orcid":false,"given":"Irene","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Mathematical Sciences and Informatics, and Health Research Institute (IdISBa), University of the Balearic Islands (UIB), 07122 Palma, Balearic Islands, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3778-3032","authenticated-orcid":false,"given":"Juan","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"ADEMA University School, University of the Balearic Islands (UIB), 07122 Palma, Balearic Islands, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1713-6759","authenticated-orcid":false,"given":"Maria","family":"Paparoupa","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2959-8216","authenticated-orcid":false,"given":"Athanasia","family":"Xirogianni","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 122 43 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Papandreou","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 122 43 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Tzanakaki","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 122 43 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1016\/S0140-6736(07)61016-2","article-title":"Epidemic meningitis, meningococcaemia, and Neisseria meningitidis","volume":"369","author":"Stephens","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"123ps125","DOI":"10.1126\/scitranslmed.3003859","article-title":"Toward a meningitis-free world","volume":"4","author":"Black","year":"2012","journal-title":"Sci. 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