Bacterial Meningitis in Young Adults in Southern Taiwan: Clinical Characteristics and Therapeutic Outcomes

Tsai, Meng-Han; Lu, Cheng-Hsien; Huang, Chi-Ren; Chuang, Yao-Chung; Tsai, Nai‐Wen; Tsai, Hsih-Hao; Chen, S.-F.; Li, C.-S.; Chang, Hsueh‐Wen; Chien, Chun-Chih; Chang, Wen-Neng

doi:10.1007/s15010-006-4144-6

Cited by 23 publications

(25 citation statements)

References 25 publications

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“…In turn, liver abscesses can give rise to a number of other secondary infections as a result of hematogenous spread from the liver. For example, community-acquired K. pneumoniae meningitis is rare in most parts of the world but is observed as an infection secondary to community-acquired liver abscess in Taiwan (89-91) as well as nosocomial infections in Taiwan (92,93). HV K. pneumoniae infections can also lead to severe skin and soft tissue infections (e.g., cellulitis, necrotizing fasciitis, and myositis), endophthalmitis, and abscesses in a number of other tissues (e.g., neck, lungs, and kidneys) (89-91, 94, 95).…”

Section: Infections Caused By K Pneumoniaementioning

confidence: 99%

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Paczosa

Mecsas

2016

Microbiol Mol Biol Rev

1,308

1,345

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SUMMARYKlebsiella pneumoniaecauses a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Historically,K. pneumoniaehas caused serious infection primarily in immunocompromised individuals, but the recent emergence and spread of hypervirulent strains have broadened the number of people susceptible to infections to include those who are healthy and immunosufficient. Furthermore,K. pneumoniaestrains have become increasingly resistant to antibiotics, rendering infection by these strains very challenging to treat. The emergence of hypervirulent and antibiotic-resistant strains has driven a number of recent studies. Work has described the worldwide spread of one drug-resistant strain and a host defense axis, interleukin-17 (IL-17), that is important for controlling infection. Four factors, capsule, lipopolysaccharide, fimbriae, and siderophores, have been well studied and are important for virulence in at least one infection model. Several other factors have been less well characterized but are also important in at least one infection model. However, there is a significant amount of heterogeneity inK. pneumoniaestrains, and not every factor plays the same critical role in all virulentKlebsiellastrains. Recent studies have identified additionalK. pneumoniaevirulence factors and led to more insights about factors important for the growth of this pathogen at a variety of tissue sites. Many of these genes encode proteins that function in metabolism and the regulation of transcription. However, much work is left to be done in characterizing these newly discovered factors, understanding how infections differ between healthy and immunocompromised patients, and identifying attractive bacterial or host targets for treating these infections.

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Section: Infections Caused By K Pneumoniaementioning

confidence: 99%

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Paczosa

Mecsas

2016

Microbiol Mol Biol Rev

1,308

1,345

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“…Recommendations 34. Neuroimaging is recommended in patients with suspected healthcare-associated ventriculitis and meningitis (strong, moderate).…”

Section: What Is the Role Of Imaging In Patients With Suspected Hmentioning

confidence: 99%

“…In a review of all causes of meningitis at Massachusetts General Hospital between 1962 and 1988, 40% were classified as nosocomial in origin [33]. In another study of confirmed bacterial meningitis in adults who were hospitalized at an acute care teaching hospital in southern Taiwan, 48% of cases were classified as nosocomial infections [34]. In a recent epidemiological study of bacterial meningitis in the United States [35], the incidence of meningitis caused by nosocomial pathogens (eg, gram-negative bacilli and S. aureus) approached that caused by Neisseria meningitidis.…”

Section: Neurosurgery or Head Traumamentioning

confidence: 99%

2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*

Tunkel

Hasbun

Bhimraj

et al. 2017

Clinical Infectious Diseases

676

671

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The Infectious Diseases Society of America (IDSA) Standards and Practice Guidelines Committee collaborated with partner organizations to convene a panel of 10 experts on healthcare-associated ventriculitis and meningitis. The panel represented pediatric and adult specialists in the field of infectious diseases and represented other organizations whose members care for patients with healthcare-associated ventriculitis and meningitis (American Academy of Neurology, American Association of Neurological Surgeons, and Neurocritical Care Society). The panel reviewed articles based on literature reviews, review articles and book chapters, evaluated the evidence and drafted recommendations. Questions were reviewed and approved by panel members. Subcategories were included for some questions based on specific populations of patients who may develop healthcare-associated ventriculitis and meningitis after the following procedures or situations: cerebrospinal fluid shunts, cerebrospinal fluid drains, implantation of intrathecal infusion pumps, implantation of deep brain stimulation hardware, and general neurosurgery and head trauma. Recommendations were followed by the strength of the recommendation and the quality of the evidence supporting the recommendation. Many recommendations, however, were based on expert opinion because rigorous clinical data are not available. These guidelines represent a practical and useful approach to assist practicing clinicians in the management of these challenging infections.

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“…The results showed that the leading Gram-positive pathogens of this study were CoNS (20, 10.9%), S. aureus (20, 10.9%), viridans streptococci(8,4.4%), Streptococcus pneumoniae (6, 3.3%) and Enterococcus spp. (5, 2.7%), and in the previous study period, Streptococcus pneumoniae (19, 10.6%), S. aureus(15,8.3%), viridans streptococci (13, 7.2%), CoNS (12, 6.7%), Enterococcus spp. (4, 2.2%).…”

mentioning

confidence: 89%

“…The prevalence rate of pathogens causing bacterial meningitis is influenced by several clinical factors, including age, preceding medical, and/or surgical conditions, mode of contraction, geographic distribution, status of vaccination, and the time period of the study [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Changing epidemiology of bacterial meningitis has been noted in several studies [5,8,10,12].…”

Section: Introductionmentioning

confidence: 99%