1077 Relationship Between the Number of Bacteria in the Blood of Children and the Clinical Disease

Sullivan, Thomas D.; Scolea, L J La; Neter, Erwin

doi:10.1203/00006450-198104001-01103

Cited by 33 publications

(48 citation statements)

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“…Meningeal invasion occurs following penetration of the cellular barriers of the CNS. High-level bacteremia was shown to be necessary for the development of meningitis in experimental animal models (20,21), which is consistent with clinical observations in humans (22)(23)(24). Bacteria that commonly cause meningitis express antiphagocytic capsular polysaccharide, which enables survival/multiplication within the blood.…”

Section: Meningitissupporting

confidence: 67%

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

et al. 2014

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SUMMARY The brain is well protected against microbial invasion by cellular barriers, such as the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). In addition, cells within the central nervous system (CNS) are capable of producing an immune response against invading pathogens. Nonetheless, a range of pathogenic microbes make their way to the CNS, and the resulting infections can cause significant morbidity and mortality. Bacteria, amoebae, fungi, and viruses are capable of CNS invasion, with the latter using axonal transport as a common route of infection. In this review, we compare the mechanisms by which bacterial pathogens reach the CNS and infect the brain. In particular, we focus on recent data regarding mechanisms of bacterial translocation from the nasal mucosa to the brain, which represents a little explored pathway of bacterial invasion but has been proposed as being particularly important in explaining how infection with Burkholderia pseudomallei can result in melioidosis encephalomyelitis.

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Section: Meningitissupporting

confidence: 67%

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

et al. 2014

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“…Compared with cases of bacteremia caused by methicillin-susceptible S. aureus (MSSA) strains, cases of bacteremia caused by MRSA strains have been shown to be associated with more persistent infections, more recurrent episodes, longer hospital stays, and higher rates of mortality (3,6,11,13,14,27). Because of the high rates of mortality and the refractoriness of MRSA bacteremia to treatment, MRSA bacteremia has become a very challenging infectious disease (18,21,38,39,42).It has recently been demonstrated that high bacterial loads in blood correlate with disease severity in patients with infections caused by Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis (4,22,35,41), as well as in a murine model of Serratia marcescens infection (25). In the case of S. aureus-related infections, it was reported that positive blood cultures during follow-up and the persistence of fever were suggestive of a complicated course (6,15,37).…”

mentioning

confidence: 99%

“…It has recently been demonstrated that high bacterial loads in blood correlate with disease severity in patients with infections caused by Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis (4,22,35,41), as well as in a murine model of Serratia marcescens infection (25). In the case of S. aureus-related infections, it was reported that positive blood cultures during follow-up and the persistence of fever were suggestive of a complicated course (6,15,37).…”

mentioning

confidence: 99%

High Levels of mecA DNA Detected by a Quantitative Real-Time PCR Assay Are Associated with Mortality in Patients with Methicillin-Resistant Staphylococcus aureus Bacteremia

Chang

Lin

et al. 2009

J Clin Microbiol

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Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is known to be a poor prognostic factor. While several PCR assays for the detection of MRSA in various clinical samples were recently reported, the possibility that a quantitative PCR assay could be used to quantify and monitor MRSA bacteremia has not been explored. In this study, we established a quantitative real-time PCR assay for the mecA gene using known copy numbers of a plasmid containing mecA DNA as a standard and the previously described mecA-specific primers and probe (P. Francois et al., J. Clin. Microbiol. 41:254-260, 2003). We employed this assay to examine 250 sequential whole-blood samples from 20 adult patients, including 13 survivors and 7 nonsurvivors, with culture-proven MRSA bacteremia at the intensive care units of National Taiwan University Hospital between 1 July 2006 and 31 January 2007. The levels of mecA DNA in the nonsurvivors were significantly higher than those in the survivors during the three periods of bacteremia examined (days 0 to 2, 3 to 5, and 6 to 8) (P ‫؍‬ 0.003 by two-tailed Mann-Whitney U test). Moreover, the nonsurvivors had higher mecA DNA levels than the survivors after 3 days and 7 days of anti-MRSA therapy (medians for nonsurvivors and survivors at 3 days, 5.86 and 4.30 log copies/ml, respectively; medians for nonsurvivors and survivors at 7 days, 5.21 and 4.36 log copies/ml, respectively; P ‫؍‬ 0.02 and P ‫؍‬ 0.04, respectively, by two-tailed Mann-Whitney U test). Together, these findings suggest that the level of mecA DNA in blood could potentially be used to monitor MRSA bacteremia and evaluate responses to therapy.Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that is one of the most common causes of both community-acquired and nosocomial infections worldwide, especially in intensive care units (ICUs) (5,8,33,49). In the past two decades, the proportion of MRSA infections has increased dramatically, and up to 60% of S. aureus isolates from ICUs were reported to be methicillin resistant (26). Compared with cases of bacteremia caused by methicillin-susceptible S. aureus (MSSA) strains, cases of bacteremia caused by MRSA strains have been shown to be associated with more persistent infections, more recurrent episodes, longer hospital stays, and higher rates of mortality (3,6,11,13,14,27). Because of the high rates of mortality and the refractoriness of MRSA bacteremia to treatment, MRSA bacteremia has become a very challenging infectious disease (18,21,38,39,42).It has recently been demonstrated that high bacterial loads in blood correlate with disease severity in patients with infections caused by Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis (4,22,35,41), as well as in a murine model of Serratia marcescens infection (25). In the case of S. aureus-related infections, it was reported that positive blood cultures during follow-up and the persistence of fever were suggestive of a complicated course (6,15,37). However, the drastic decrease in the sen...

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“…K1 strains possessing certain 0 types may resist clearance from the bloodstream, thus allowing replication to a level that is required for meningeal invasion. Several studies in humans and experimental animals suggest a relationship between the magnitude of bacteremia and the development of meningitis (27)(28)(29)(30)(31) of certain KI E. coli serotypes with neonatal meningitis is the ability to escape from host defenses and to achieve a threshold level of bacteremia necessary for meningeal invasion.…”

Section: Resultsmentioning

confidence: 99%

The K1 capsule is the critical determinant in the development of Escherichia coli meningitis in the rat.

et al. 1992

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Although Escherichia coli strains possessing the Kl capsule are predominant among isolates from neonatal E. coli meningitis and most of these Kl isolates are associated with a limited number of 0 lipopolysaccharide (LPS) types, the basis of this association of Kl and certain 0 antigens with neonatal E. coli meningitis is not clear. The present study examined in experimental E. coli bacteremia and meningitis in newborn and adult rats whether or not the Kl capsule and/or 0-LPS antigen are critical determinants in the development of meningitis. Rats received subcutaneously a Kl E. coli strain (018+K1+) or mutants lacking either the Kl capsule (018+K1-) or 0 side-chain (018-K1+). 12-24 h later, blood and cerebrospinal fluid (CSF) specimens were obtained for quantitative cultures. The isolation of E. coli from CSF was observed in both newborn and adult rats infected with K1+ strains regardless of LPS phenotype (018+ or 18-) who also developed a high degree of bacteremia (e.g., > 104 CFU/ml of blood). In contrast, none of the newborn and adult rats infected with 018+K1-and developing bacteremia of > 10' were found to have positive CSF cultures.These findings indicate that the presence of the Kl capsule and a high degree ofbacteremia are key determinants in the development of E. coli meningitis, suggesting that there may be specific binding sites present in the brain which have an affinity for the Kl capsule and thus may be responsible for the entry of Kl-encapsulated E. coli into the meninges. (J. Clin. Invest. 1992. 90:897-905.)

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1077 Relationship Between the Number of Bacteria in the Blood of Children and the Clinical Disease

Cited by 33 publications

References 0 publications

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

High Levels of mecA DNA Detected by a Quantitative Real-Time PCR Assay Are Associated with Mortality in Patients with Methicillin-Resistant Staphylococcus aureus Bacteremia

The K1 capsule is the critical determinant in the development of Escherichia coli meningitis in the rat.

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