Aetiologies of Central Nervous System Infection in Viet Nam: A Prospective Provincial Hospital-Based Descriptive Surveillance Study

Abstract

BackgroundInfectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.MethodsWe conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007– April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.ResultsWe recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52%) of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24%) and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%). Mycobacterium tuberculosis was confirmed in 34/617 (6%) adult patients and 11/624 (2%) paediatric patients. The acute case fatality rate (CFR) during hospital admission was 73/617 (12%) in adults and to 42/624 (7%) in children.ConclusionsZoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia

“…This result is much higher than several studies noted that the incidence of intracranial postneurosurgical infection have been ranged between 0.4% to 7.7% [4,5,6,7]. The profile of CSF isolates in this study showed that certain bacteria species were the predominant cause of CNS infection and was similar to other studies [1,2,8,10] . Coagulase negative Staphylococci was responsible for 39.4 of CSF positive culture, which was similar to a recent Iranian study [16].…”

“…CNS infections are life-threatening and significant causes of morbidity and mortality, especially in developing countries [1,2]. Bacterial infections have been known as the most common cause of the CNS infections, meanwhile fungi and mycobacteria are also frequently reported [3].…”

“…Bacterial infections have been known as the most common cause of the CNS infections, meanwhile fungi and mycobacteria are also frequently reported [3]. The pattern of pathogens recovered from CSF culture varies from Gram-positive cocci to multidrug-resistant Gram-negative bacteria depending on geographic region, age, co-morbidities, type of neurosurgical procedures, and site of infection [1,4,5].…”

Acute Bacterial Meningitis among Children Admitted into an Iranian Referral Children's Hospital

“…The identification of the bacterial causes of meningitis infections in developing countries is difficult due to the limited number of bacteriological culture facilities and lack of BACTEC automated culture system (15). In the present study, we used the BACTEC culture system to improve the yield of clinically significant isolates from normally sterile body fluids and reduce the time required for microorganism detection (16).…”

Dengue Associated Acute Encephalitis Syndrome Cases in Son La Province, Vietnam in 2014

“…CSF samples were not available from all the patients. Other AES agents, including bacteria and parasites, have been suggested as causative agents of AES for patients negative for antiflavivirus antibodies (2,(14)(15)(16)(17). In Vietnam, anti-JEV IgM positivity among AES patients varies from 17 to 71 (9).…”