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Bacterial meningitis

Silvia Garcia, Janire Echevarri, Eunate Arana-Arri, Mercedes Sota, Javier Benito, Santiago Mintegi
OBJECTIVE: To determine the outcome of children aged 2-14 years with cerebrospinal fluid (CSF) pleocytosis and at very low risk for bacterial meningitis managed as outpatients without antibiotics. METHODS: Multicentre, prospective, observational study conducted at nine Spanish paediatric EDs. Patients were diagnosed with meningitis based on clinical suspicion of meningitis and CSF pleocytosis when evaluated in the ED. Children between 2 and 14 years of age with pleocytosis and very low-risk criteria for bacterial meningitis (well appearing, Bacterial Meningitis Score (BMS)=0, procalcitonin (PCT)<0...
March 21, 2018: Emergency Medicine Journal: EMJ
Anna Moniuszko-Malinowska, Paweł Penza, Piotr Czupryna, Olga Zajkowska, Sławomir Pancewicz, Renata Świerzbińska, Justyna Dunaj, Joanna Zajkowska
AIM: The aim of the study was to determine HMGB-1 concentration in serum and cerebrospinal fluid (CSF) of patients suffering from tick-borne encephalitis (TBE) and neuroborreliosis (NB). We focused on HMGB-1 measurement in CSF or sera in order to establish whether it could help to differentiate between NB and TBE. METHODS: 80 patients with meningitis and meningoencephalitis were enrolled in the study. Patients were divided into two groups: Group I - patients with NB (n=40) and Group II - patients with TBE (n=40)...
March 17, 2018: International Journal of Infectious Diseases: IJID
Guojun Zhang, Guanghui Zheng, Yan Zhang, Ruimin Ma, Xixiong Kang
Post-neurosurgical meningitis (PNM) is one of the most severe hospital-acquired infections (HAI) worldwide, and a large number of pathogens, especially those possessing multi-resistance genes, are related to these infections. Existing methods for detecting bacteria and measuring their response to antibiotics lack sensitivity and stability, and laboratory-based detection methods are inconvenient, which require at least 24h to complete. Rapid identification of bacteria and the determination of their susceptibility to antibiotics are urgently needed, in order to combat the emergence of multi-resistant bacterial strains...
March 17, 2018: International Journal of Infectious Diseases: IJID
Bente Børud, Guro K Bårnes, Ola Brønstad Brynildsrud, Elisabeth Fritzsønn, Dominique A Caugant
Species within the genus Neisseria display significant glycan diversity associated with the O -linked protein glycosylation ( pgl ) systems due to phase variation, polymorphic genes and gene content. The aim of this study was to examine in detail the pgl genotype and glycosylation phenotype in meningococcal isolates and the changes occurring during short-term asymptomatic carriage. Paired meningococcal isolates derived from 50 asymptomatic meningococcal carriers, taken about two months apart, were analyzed with whole genome sequencing...
March 19, 2018: Journal of Bacteriology
Samia N Naccache, Maryann Lustestica, Margil Fahit, Javier Mestas, Jennifer Dien Bard
Early establishment of infectious process allows for expedited clinical management of meningitis and encephalitis. The FilmArray Meningitis/Encephalitis (FA-M/E) panel provides rapid detection of potential pathogens associated with encephalitis/meningitis in both immunocompetent and compromised patients. Here we conducted a one year review of the performance of the FA-M/E panel at a tertiary care children's hospital. 265 samples from 251 patients were tested. 87.25% (219/251) were negative, 9.96% (25/251) were positive for viral analytes and 3...
March 14, 2018: Journal of Clinical Microbiology
Mona Noureldein, Roxana Mardare, Jack Pickard, Hoi Lun Shing, Michael Eisenhut
BACKGROUND: It has been estimated that paediatric meningitis without elevated CSF white cell count (pleocytosis) accounts for 0.5-12% of all cases of bacterial meningitis. CSF protein and glucose measurements are therefore essential in management but may be neglected in clinical practice. In order to improve recognition of bacterial meningitis in neonates and to enable adequate management and audit, we investigated whether a systemic inflammatory response in the absence of meningitis is associated with elevated CSF protein and reduced CSF glucose levels...
March 14, 2018: Fluids and Barriers of the CNS
Royce Johnson, Jackie Ho, Pete Fowler, Arash Heidari
PURPOSE OF REVIEW: This article summarizes the diagnosis and treatment of coccidioidal meningitis (CM) and its complications. An overview of current and prospective pharmacologic treatment options and monitoring parameters is provided. A consensus has not been reached regarding universally accepted therapeutic serum levels for azoles because of insufficient evidence. We describe the preferred therapeutic drug level ranges that our institution uses to monitor azole therapy. RECENT FINDINGS: Ho et al...
March 13, 2018: Current Neurology and Neuroscience Reports
Ewelina Gowin, Bogna Świątek-Kościelna, Ewelina Kałużna, Ewa Strauss, Jacek Wysocki, Jerzy Nowak, Michał Michalak, Danuta Januszkiewicz-Lewandowska
The aim of this study is to describe the prevalence of single single-nucleotide polymorphisms (SNPs) as well as their combinations in genes encoding proteins involved in the immune response in children with bacterial meningitis. The prospective study group consisted of 39 children with bacterial meningitis and 49 family members surveyed between 2012 and 2016. Eleven SNPs in five genes involved in immune response were analysed. The mean number of minor frequency alleles (MAF) of studied SNPs was lowest in the control group and highest in patients with pneumococcal meningitis...
January 1, 2018: Innate Immunity
Mariia Karppinen, Atte Sjövall, Tuula Pelkonen, Luis Bernardino, Irmeli Roine, Anne Pitkäranta, Antti A Aarnisalo, Päivi Nevalainen, Leena Lauronen
Objective: To assess the role of single and repeated auditory brain stem response (ABR) in predicting mortality and severe neurological injury among children having bacterial meningitis (BM) in Luanda, Angola. Methods: The morphology of ABR traces of 221 children (aged 2 months to 12 years) from admission day was analyzed and compared with age-matched normative data. Absence and delay of traces were compared with mortality and mortality or severe neurological injury in subgroup analyses...
2018: Clinical Medicine Insights. Ear, Nose and Throat
Seungyeop Lee, Si-On Lee, Gyu-Lee Kim, Dong-Kwon Rhee
AIMS: Streptococcus pneumoniae infection in acute bacterial meningitis can lead to widespread brain damage and mortality. Inflammatory responses by immune cells in the brain are thought to determine the degree of brain injury. Yet, the mechanisms underlying host responses to pneumococcal meningitis are largely unknown. To explore host responses as a potential therapeutic target for preventing brain injury after pneumococcal meningitis. METHODS: We evaluated signaling mechanisms that minimize neuronal damage caused by pneumococcal infection; specifically, we assessed pathways related to neuronal survival after enhancing estrogen receptor-β (ER-β) expression using a natural therapeutic substance known as ginsenoside Rb1 and Rg3 enhanced ginseng...
March 9, 2018: CNS Neuroscience & Therapeutics
Alexander Pschibul, Wibke G Janzarik, Peter Franck, Markus Hufnagel, Christopher Beck, Rudolf Korinthenberg
Despite the availability of modern antibiotics, pneumococcal meningitis in both children and adults remains a severe disease-one known to frequently cause grave complications and residual disability. Although the appearance of arterial vasospasms in bacterial meningitis systematically has been investigated and reported on for adult patients, such research is lacking when it comes to infants. We report on a 4-week-old infant who, 6 days after onset of pneumococcal meningitis, suffered severe neurological deterioration with treatment-resistant seizures and coma...
March 9, 2018: Neuropediatrics
Joost M Costerus, Matthijs C Brouwer, Marieke E S Sprengers, Stefan D Roosendaal, Arie van der Ende, Diederik van de Beek
Background: It is unclear how often lumbar puncture (LP) is complicated by cerebral herniation in patients with bacterial meningitis and whether cranial CT can be used to identify patients at risk for herniation. Methods: We performed a nationwide prospective cohort study of patients with community-acquired bacterial meningitis from 2006 to 2014 and identified patients with clinical deterioration possibly caused by LP. For systematic evaluation of contraindications for LP on cranial CT, these patients were matched to patients in the cohort without deterioration...
March 7, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Anita Jeyakumar, Rodolpho E Bégué, Yu Jiang, Brian J McKinnon
OBJECTIVE: Guidelines for vaccination of cochlear implant (CI) recipients have been promulgated and updated by the Center for Disease Control and Prevention (CDC) to mitigate bacterial meningitis risk. The objective of this study was to survey current CI specialists on: 1) knowledge of current CDC CI recipient immunization recommendations, and 2) impediments to implementation of those guidelines. METHODS: A survey to assess knowledge of the CI recipient vaccination guidelines was administered to the American Academy of Otolaryngology-Head and Neck surgery (AAO-HNS), the American Cochlear Implant Alliance (ACIA), and the American Neurotology Society (ANS)...
March 9, 2018: Laryngoscope
Manju Ohri, Smriti Parashar, Venkatesh S Pai, Sujata Ghosh, Anuradha Chakraborti
Group B streptococcus (GBS) or Streptococcus agalactiae, is an opportunistic pathogen causing a wide range of infections like pneumonia, sepsis, and meningitis in newborn, pregnant women and adults. While this bacterium has adapted well to asymptomatic colonization of adult humans, it still remains a potentially devastating pathogen to susceptible infants. Advances in molecular techniques and refinement of in vitro and in vivo model systems have elucidated key elements of the pathogenic process, from initial attachment to the maternal vaginal epithelium to penetration of the newborn blood-brain barrier...
March 8, 2018: World Journal of Microbiology & Biotechnology
Nathan Ford, Graeme Meintjes, Alexandra Calmy, Helen Bygrave, Chantal Migone, Marco Vitoria, Martina Penazzato, Lara Vojnov, Meg Doherty
In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Taty Tshimangani, Jean Pongo, Joseph Bodi Mabiala, Marcel Yotebieng, Nicole F O'Brien
Empirical knowledge suggests that acute neurologic disorders are common in sub-Saharan Africa, but studies examining the true burden of these diseases in children are scarce. We performed this prospective, observational study to evaluate the prevalence, clinical characteristics, treatment approaches, and outcomes of children suffering acute neurologic illness or injury (ANI) in an urban and rural site in the Democratic Republic of the Congo. Over 12 months, 471 out of 6,563 children admitted met diagnostic criteria for ANI, giving a hospital-based prevalence of 72/1,000 admissions...
March 5, 2018: American Journal of Tropical Medicine and Hygiene
Uri Obolski, José Lourenço, Craig Thompson, Robin Thompson, Andrea Gori, Sunetra Gupta
The bacterial pathogen Streptococcus pneumoniae is a major public health concern, being responsible for more than 1.5 million deaths annually through pneumonia, meningitis, and septicemia. Available vaccines target only a subset of serotypes, so vaccination is often accompanied by a rise in the frequency of nonvaccine serotypes. Epidemiological studies suggest that such a change in serotype frequencies is often coupled with an increase of antibiotic resistance among nonvaccine serotypes. Building on previous multilocus models for bacterial pathogen population structure, we have developed a theoretical framework incorporating variation of serotype and antibiotic resistance to examine how their associations may be affected by vaccination...
March 6, 2018: Proceedings of the National Academy of Sciences of the United States of America
Valerie S Forsyth, Chelsie E Armbruster, Sara N Smith, Ali Pirani, A Cody Springman, Matthew S Walters, Greta R Nielubowicz, Stephanie D Himpsl, Evan S Snitkin, Harry L T Mobley
Uropathogenic Escherichia coli (UPEC) strains cause most uncomplicated urinary tract infections (UTIs). These strains are a subgroup of extraintestinal pathogenic E. coli (ExPEC) strains that infect extraintestinal sites, including urinary tract, meninges, bloodstream, lungs, and surgical sites. Here, we hypothesize that UPEC isolates adapt to and grow more rapidly within the urinary tract than other E. coli isolates and survive in that niche. To date, there has not been a reliable method available to measure their growth rate in vivo Here we used two methods: segregation of nonreplicating plasmid pGTR902, and peak-to-trough ratio (PTR), a sequencing-based method that enumerates bacterial chromosomal replication forks present during cell division...
March 6, 2018: MBio
M Munk, F R Poulsen, L Larsen, C H Nordström, T H Nielsen
BACKGROUND: Cerebral mitochondrial dysfunction is prominent in the pathophysiology of severe bacterial meningitis. In the present study, we hypothesize that the metabolic changes seen after intracisternal lipopolysaccharide (LPS) injection in a piglet model of meningitis is compatible with mitochondrial dysfunction and resembles the metabolic patterns seen in patients with bacterial meningitis. METHODS: Eight pigs received LPS injection in cisterna magna, and four pigs received NaCl in cisterna magna as a control...
March 5, 2018: Neurocritical Care
Silas F Eto, Dayanne C Fernandes, Alessandra C Moraes, Ed Johnny R Prado, Amanda C Baldassi, Wilson G Manrique, Ives C Silva, Andrea S R Medeiros, Marco A A Belo, Tiago S Balbuena, Samir I Samara, João M Pizauro
Streptococcus agalactiae (Sta), which belongs to Lancefield group B, causes sepsis, endocarditis and bacterial meningitis in human neonates and Nile tilapia. Because the pathophysiology of Sta infection is partially similar in both species, the identification of biomarkers for the diagnosis and study of this disease is of importance for human and animal health. Therefore, in the present study, we produced an immunoglobulin Y (IgY) by immunizing laying hens with Sta proteins and evaluated its ability to detect Sta in paraffinized tilapia brain and cardiac tissue by direct immunofluorescence (IMF) and indirect immunohistochemistry (IHC)...
March 1, 2018: Fish & Shellfish Immunology
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