Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea

Moon, Soo-youn; Chung, Doo Ryeon; Kim, S.-W.; Chang, Hyun Ha; Lee, H.; Jung, Dong Sik; Kim, Y.-S.; Jung, Sook-In; Ryu, Seong Yeol; Heo, Sang Taek; Moon, Chisook; Ki, Hyun Kyun; Son, Jun Seong; Kwon, Ki Tae; Shin, Sohee; Lee, J. S.; Lee, S. S.; Rhee, Ji-Young; Lee, J.-A.; Joung, Mi Kyong; Cheong, Hae Suk; Peck, Kyong Ran; Song, Jae Hoon

doi:10.1007/s10096-010-0929-8

Cited by 40 publications

(28 citation statements)

References 31 publications

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“…It was also found that large-area cerebral infarction occurs in mice in which the NT-4/5 receptor gene was knocked out, indicating that NT-4/5 can reduce the cerebral susceptibility to ischemic injury. In addition, NT-4/5 can promote the survival, growth, and differentiation of neurons, and protect the hippocampus and cortical neurons from excitatory toxins and metabolic injury (Moon et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Expression of neurotrophin-4/5 in Streptococcus pneumoniae meningitis

Zhang¹,

Qian²,

Li³

2014

Genet. Mol. Res.

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ABSTRACT. This study aims to investigate the expression of neurotrophin-4/5 (NT-4/5) in the pallium and hippocampus in juvenile rats with intraventricular injection of Streptococcus pneumoniae. We used 40 SPF SD rats (3 weeks old, regardless of gender) in this study. We drew 50 μL cerebrospinal fluid, and then, we injected 50 μL normal saline and S. pneumoniae suspension (10 8 CFU/mL) in the brain pool (normal control group and infection group, respectively). After 24 h, the cerebrospinal fluid was collected for bacterial culture and white blood cell count. The immunohistochemical staining was conducted at the day 1, 2, and 5, and the expression of NT-4/5 in rat brain tissue was observed. Compared with the normal control group, NT-4/5 expression in the pallium and hippocampus of rats in the 24-h infection group was significantly increased (both P < 0.05). NT-4/5 expression in the pallium and hippocampus in the 5-day infection group was significantly Expression of neurotrophin-4/5 in meningitis lower than that in the 24-h infection group (P < 0.05), and they were significantly higher than the normal control group (P < 0.05). After intraventricular injection of S. pneumoniae, the expression of NT-4/5 in the pallium and hippocampus in juvenile rats was increased, especially during early disease course.

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Section: Discussionmentioning

confidence: 99%

Expression of neurotrophin-4/5 in Streptococcus pneumoniae meningitis

Zhang¹,

Qian²,

Li³

2014

Genet. Mol. Res.

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“…Streptococcus pneumoniae has been the most common etiology of community-acquired, bacterial meningitis in adults in most countries [1][2][3][4], and high rates of mortality and neurological sequelae in pneumococcal meningitis have been problematic despite antibiotic therapy and advanced critical care [1][2][3][4][5]. Severe inflammatory response in the subarachnoid space of the patients with bacterial meningitis receiving antibiotic treatment has been known to be associated with mortality and neurological sequelae [6].…”

Section: Introductionmentioning

confidence: 99%

Is adjunctive corticosteroid beneficial in pneumococcal meningitis in a region with high rates of resistance to penicillin and ceftriaxone?

et al. 2012

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The role of adjunctive corticosteroids remains controversial in meningitis by penicillin-resistant pneumococci. We determined the effect of adjunctive corticosteroids in adults with pneumococcal meningitis in a region with a high rate of penicillin resistance. A multicenter, retrospective cohort study was conducted between 1998 and 2008 in Korea. The mortality and neurological sequelae were evaluated. Among 93 patients with pneumococcal meningitis, adequate adjunctive corticosteroids were given in 45.2%. The penicillin resistance rate was 60.0%, and 42.1% were nonsusceptible to ceftriaxone. The 30-day mortality rates in the group receiving adequate corticosteroid therapy, the group in which corticosteroid was not given, and that inadequately given were 24.3, 31.6, and 27.3%, respectively, and there was no difference between the groups. The rates of development of neurological sequelae were 34.3, 33.3, and 43.5%, respectively. Multivariate analysis showed that adequate corticosteroids did not reduce mortality (HR 0.773, 95% CI 0.293-2.040) and neurologic sequelae (HR 0.604, CI 0.262-1.393). Propensity-adjusted analysis showed that adjunctive corticosteroid was not associated with time to death (HR 0.949, CI 0.374-2.408), however, a decreasing tendency was shown in neurologic sequelae in the adequate corticosteroid group (HR 0.479, CI 0.207-1.110). In conclusion, adjunctive corticosteroids did not affect mortality in adults with pneumococcal meningitis in a region with high rates of resistance to penicillin and ceftriaxone; however, the patients receiving adequate corticosteroid therapy tended to develop neurologic sequelae less frequently.

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“…Epidemiologic trends between western and eastern countries appear to differ in the percentage contributions of the major species inducing bacterial and fungal meningitis. In surveys from western countries, Escherichia coli was the leading pathogen among aerobic Gram-negative bacilli, which account for 4.3-12.3% of the pathogens causing bacterial meningitis [6]. In Asia, Klebsiella pneumoniae was the most common among the implicated Gram-negative pathogens and the overall incidence of meningitis caused by Gram-negative bacilli is 7.6-28.8% [6,7], which is about twice the incidence in western countries.…”

Section: Introductionmentioning

confidence: 99%

The microbiology and clinical characteristics of bacterial and fungal meningitis in a Chinese hospital

Chen¹,

Hu²,

Liu³

2017

Arch Med Sci Civil Dis

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A b s t r a c t Introduction:The aim was to investigate the distribution, antibiotic resistance, initial clinical and laboratory characteristics of pathogens isolated from the cerebrospinal fluid samples (CSF). Material and methods: The CSF were subjected for identification. The minimum inhibitory concentrations (MICs) of antimicrobial agents were tested. The initial clinical and laboratory characteristics were collected. Results: The rate of positive yield of pathogen meningitis in our study was 8.16% . Among the 1994 non-repetitive pathogens, Gram-positive pathogen was the most common (71.71%), followed by Gram-negative pathogen (20.36%), fungal (6.62%) and Mycobacterium tuberculosis (1.30%). Coagulase-negative staphylococci (CNS) was the most common Gram-positive pathogen and Acinetobacter baumannii (Ab) was the most common Gram-negative pathogen. As to fungal pathogen, Cryptococcus neoformans (CN) was the most common. The main CNS showed higher antimicrobial resistant rate for Penicillin G, oxacillin, clindamycin and erythromycin. Acinetobacter baumannii resistant to the most tested antibiotics and only showed considerable rate of resistance to cefoperazone/sulbactam, tigecycline and amikacin. All CN were susceptible to 5-fluorocytosine and only 3.6% CN were resistance to fluconazole. Long days of hospital stay, fever and meningeal irritation signs were common symptoms in the bacterial and fungal meningitis. Head injury, disturbance of consciousness, the pupil size of both eyes was not equal, pupillary reaction to light was slow or absent were more common in the Ab meningitis. The CSF protein concentration and white blood cells count as well as glucose concentration can be used in guiding initial treatment and further microbiological investigation. Conclusions: The main pathogens showed higher antimicrobial resistant rate and the selection of empiric antibiotics should take into consideration local epidemiology, antibiotic resistance patterns and the suspected causative microorganism.

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Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea

Cited by 40 publications

References 31 publications

Expression of neurotrophin-4/5 in Streptococcus pneumoniae meningitis

Expression of neurotrophin-4/5 in Streptococcus pneumoniae meningitis

Is adjunctive corticosteroid beneficial in pneumococcal meningitis in a region with high rates of resistance to penicillin and ceftriaxone?

The microbiology and clinical characteristics of bacterial and fungal meningitis in a Chinese hospital

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