Treatment of bacterial meningitis: an update

Shin, Seon Hee; Kim, Kwang Sik

doi:10.1517/14656566.2012.724399

Cited by 24 publications

(14 citation statements)

References 115 publications

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“…For the ABM group, we recruited participants (patient/carer pairs) for in-depth narrative interviews identified as adult and paediatric hospital in-patients between March and November 2010 using a purposive sampling framework based on patient outcomes since we expected differences in treatment seeking behaviours across adults and children [17], [18] and across outcomes [19]: adult with positive outcome (recovery with no major disability); child with positive outcome; adult with negative outcome (death or long-term disability); and child with negative outcome. Recruitment was a two-staged process beginning with initial informed consent from carers of patients admitted to hospital with proven or probable bacterial meningitis.…”

Section: Methodsmentioning

confidence: 99%

Recognising and Treatment Seeking for Acute Bacterial Meningitis in Adults and Children in Resource-Poor Settings: A Qualitative Study

et al. 2013

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ObjectiveHigh mortality burden from Acute Bacterial Meningitis (ABM) in resource-poor settings has been frequently blamed on delays in treatment seeking. We explored treatment-seeking pathways from household to primary health care and referral for ABM in Malawi.DesignA cross-sectional qualitative study using narrative in-depth interviews, semi-structured interviews and focus group discussions.ParticipantsAdults and children with proven and probable acute bacterial meningitis and/or their carers; adults from urban and peri-urban communities; and primary health care workers (HCW).SettingQueen Elizabeth Central Hospital (QECH), urban and peri-urban private and government primary health centres and communities in Blantyre District, Malawi.ResultsWhilst communities associated meningitis with a stiff neck, in practice responses focused on ability to recognise severe illness. Misdiagnosis of meningitis as malaria was common. Subsequent action by families depended on the extent to which normal social life was disrupted by the illness and depended on the age and social position of the sufferer. Seizures and convulsions were considered severe symptoms but were often thought to be malaria. Presumptive malaria treatment at home often delayed formal treatment seeking. Further delays in treatment seeking were caused by economic barriers and perceptions of inefficient or inadequate primary health services.ConclusionsGiven the difficulties in diagnosis of meningitis where malaria is common, any intervention for ABM at primary level must focus on recognising severe illness, and encouraging action at the household, community and primary health levels. Overcoming barriers to recognition and social constraints at community level require broad community-based strategies and may provide a route to addressing poor clinical outcomes.

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Section: Methodsmentioning

confidence: 99%

Recognising and Treatment Seeking for Acute Bacterial Meningitis in Adults and Children in Resource-Poor Settings: A Qualitative Study

et al. 2013

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“…The increasing number of strains resistant to traditional antibiotics has driven research into developing novel drugs for treating meningococcal infections [13]. Since virulence of this pathogen is tightly coupled to the availability of iron in the local environment of the host, one antimicrobial strategy is to disrupt its iron uptake system.…”

Section: Introductionmentioning

confidence: 99%

Spectroscopic evidence for a 5-coordinate oxygenic ligated high spin ferric heme moiety in the Neisseria meningitidis hemoglobin binding receptor

Mokry

Nadia-Albete

Johnson

et al. 2014

Biochimica et Biophysica Acta (BBA) - General Subjects

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Background For many pathogenic microorganisms, iron acquisition represents a significant stress during the colonization of a mammalian host. Heme is the single most abundant source of soluble iron in this environment. While the importance of iron assimilation for nearly all organisms is clear, the mechanisms by which heme is acquired and utilized by many bacterial pathogens, even those most commonly found at sites of infection, remain poorly understood. Methods An alternative protocol for the production and purification of the outer membrane hemoglobin receptor (HmbR) from the pathogen Neisseria meningitidis has facilitated a biophysical characterization of this outer membrane transporter by electronic absorption, circular dichroism, electron paramagnetic resonance, and resonance Raman techniques. Results HmbR co-purifies with 5-coordinate high spin ferric heme bound. The heme binding site accommodates exogenous imidazole as a sixth ligand, which results in a 6-coordinate, low-spin ferric species. Both the 5- and 6-coordinate complexes are reduced by sodium hydrosulfite. Four HmbR variants with a modest decrease in binding efficiency for heme have been identified (H87C, H280A, Y282A, and Y456C). These findings are consistent with an emerging paradigm wherein the ferric iron center of bound heme is coordinated by a tyrosine ligand. Conclusion In summary, this study provides the first spectroscopic characterization for any heme or iron transporter in Neisseria meningitidis, and suggests a coordination environment heretofore unobserved in a TonB-dependent hemin transporter. General Significance A detailed understanding of the nutrient acquisition pathways in common pathogens such as N. meningitidis provides a foundation for new antimicrobial strategies.

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“…The formation of tight junctions is a major characteristic of BMECs, which largely blocks the entry of circulating bacterial pathogens, and is widely reported to be critical for the structure as well as the function of the BBB5. However, some bacteria, such as Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b, Group B streptococcus and Escherichia coli K1, can nonetheless break through the BBB via different strategies, thereby invading the CNS and causing bacterial meningitis67891011.…”

mentioning

confidence: 99%

Differential transcription profiles of long non-coding RNAs in primary human brain microvascular endothelial cells in response to meningitic Escherichia coli

Yang

Huang²,

et al. 2016

Sci Rep

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Accumulating studies have indicated the influence of long non-coding RNAs (lncRNAs) on various biological processes as well as disease development and progression. However, the lncRNAs involved in bacterial meningitis and their regulatory effects are largely unknown. By RNA-sequencing, the transcriptional profiles of host lncRNAs in primary human brain microvascular endothelial cells (hBMECs) in response to meningitic Escherichia coli were demonstrated. Here, 25,257 lncRNAs were identified, including 24,645 annotated lncRNAs and 612 newly found ones. A total of 895 lncRNAs exhibited significant differences upon infection, among which 382 were upregulated and 513 were downregulated (≥2-fold, p < 0.05). Via bioinformatic analysis, the features of these lncRNAs, their possible functions, and the potential regulatory relationships between lncRNAs and mRNAs were predicted. Moreover, we compared the transcriptional specificity of these differential lncRNAs among hBMECs, human astrocyte cell U251, and human umbilical vein endothelial cells, and demonstrated the novel regulatory effects of proinflammatory cytokines on these differential lncRNAs. To our knowledge, this is the first time the transcriptional profiles of host lncRNAs involved in E. coli-induced meningitis have been reported, which shall provide novel insight into the regulatory mechanisms behind bacterial meningitis involving lncRNAs, and contribute to better prevention and therapy of CNS infection.

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Treatment of bacterial meningitis: an update

Cited by 24 publications

References 115 publications

Recognising and Treatment Seeking for Acute Bacterial Meningitis in Adults and Children in Resource-Poor Settings: A Qualitative Study

Recognising and Treatment Seeking for Acute Bacterial Meningitis in Adults and Children in Resource-Poor Settings: A Qualitative Study

Spectroscopic evidence for a 5-coordinate oxygenic ligated high spin ferric heme moiety in the Neisseria meningitidis hemoglobin binding receptor

Differential transcription profiles of long non-coding RNAs in primary human brain microvascular endothelial cells in response to meningitic Escherichia coli

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