Bacterial Infections of the Central Nervous System

Suthar, Renu; Sankhyan, Naveen

doi:10.1007/s12098-017-2477-z

Cited by 48 publications

(38 citation statements)

References 27 publications

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“…Although many bacterial pathogens are known to invade the CNS and cause associated neuropathologies, much less is known about their intracellular manipulation of neural cells, particularly early events of bacterial infections, and how such bacterium-induced neural cell alterations could lead to bacterial survival, persistence, and the progression of infection as well as pathogenesis. A majority of the studies with these bacterial pathogens are immune-centric and focused on inflammatory aspects of nervous system diseases, and many reviews are available elsewhere with more detail on inflammatory and immune mechanisms of this bacteria-induced neurodegeneration (1–3).…”

Section: Introductionmentioning

confidence: 99%

Cell Biology of Intracellular Adaptation of Mycobacterium leprae in the Peripheral Nervous System

Hess

Rambukkana

2019

Microbiol Spectr

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The mammalian nervous system is invaded by a number of intracellular bacterial pathogens which can establish and progress infection in susceptible individuals. Subsequent clinical manifestation is apparent with the impairment of the functional units of the nervous system, i.e., the neurons and the supporting glial cells that produce myelin sheaths around axons and provide trophic support to axons and neurons. Most of these neurotrophic bacteria display unique features, have coevolved with the functional sophistication of the nervous system cells, and have adapted remarkably to manipulate neural cell functions for their own advantage. Understanding how these bacterial pathogens establish intracellular adaptation by hijacking endogenous pathways in the nervous system, initiating myelin damage and axonal degeneration, and interfering with myelin maintenance provides new knowledge not only for developing strategies to combat neurodegenerative conditions induced by these pathogens but also for gaining novel insights into cellular and molecular pathways that regulate nervous system functions. Since the pathways hijacked by bacterial pathogens may also be associated with other neurodegenerative diseases, it is anticipated that detailing the mechanisms of bacterial manipulation of neural systems may shed light on common mechanisms, particularly of early disease events. This chapter details a classic example of neurodegeneration, that caused by Mycobacterium leprae, which primarily infects glial cells of the peripheral nervous system (Schwann cells), and how it targets and adapts intracellularly by reprogramming Schwann cells to stem cells/progenitor cells. We also discuss implications of this host cell reprogramming by leprosy bacilli as a model in a wider context.

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Section: Introductionmentioning

confidence: 99%

Cell Biology of Intracellular Adaptation of Mycobacterium leprae in the Peripheral Nervous System

Hess

Rambukkana

2019

Microbiol Spectr

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“…Bacterial meningitis (BM) is an infectious disease associated with high lethality and morbidity, and survivors could have long-term sequelae. 1–4…”

Section: Introductionmentioning

confidence: 99%

Pediatric meningitis due to Neisseria meningitidis, Streptococcus pneumoniae and Group B Streptococcus in Tijuana, Mexico: active/prospective surveillance, 2005–2018

Chacón-Cruz¹,

Roberts

Rivas-Landeros

et al. 2019

Therapeutic Advances in Infection

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Introduction:In Mexico, Neisseria meningitidis is considered to be a rare cause of bacterial meningitis (BM), however, one national publication using active surveillance has suggested the opposite. Group B Streptococcus (GBS) is also considered to be infrequent in young infants as a cause of BM in central Mexico. Streptococcus pneumoniae vaccination using the 13-valent conjugate vaccine (PCV13) started in our region in May 2012. We focused our research on whether N. meningitidis and GBS are important causes of BM, and to examine the effectiveness of PCV13 on pneumococcal BM.Methods:From October 2005 to September 2018, active/prospective surveillance looking for all patients admitted with suspected BM <16 years of age was performed at the Tijuana, Mexico, General Hospital. Tijuana, Mexico to San Diego, Unites States of America (USA), is the most transited border in the world. Isolation of pathogens was by either conventional culture or Real Time-polymerase chain reaction (RT-PCR), all patients were followed during and 3 months after discharge, and a descriptive analysis was performed. The effectiveness of PCV13 was determined by comparing the proportion of cases per month on pneumococcal BM before and after its implementation.Results:There were 86 confirmed BM cases. N. meningitidis was the leading cause (60.5%, and 61.5% caused by serogroup C), followed by S. pneumoniae (18.6%). PCV13 effectiveness on pneumococcal BM was of 64.3% and was associated with the disappearance of serotype 19A. A total of 22 infants <3 months old had BM; GBS was the leading cause at this age group (27.3%), followed by N. meningitidis (22.7%). The overall mortality was 24%.Conclusions:BM by N. meningitidis is endemic in Tijuana, Mexico, and meningococcal vaccination should be seriously considered in the region. PCV13 is currently showing high effectiveness on pneumococcal BM, and we need to continue active surveillance to see whether maternal screening/prophylaxis for GBS should also be introduced in the region.

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“…Brain inflammation can also cause SE (10, 11), including central nervous system (CNS) infections and autoimmune encephalitis (12). These conditions can be treated and may result in significantly different outcomes (13–15). Altered mental status is the most common initial presentation of inflammatory SE (12).…”

Section: Introductionmentioning

confidence: 99%

“…Laboratory tests such as bacterial or viral culture, polymerase chain reaction (PCR) for specific pathogens, or autoantibody testing may not be immediately available (13, 16) and the results may take a few days or weeks to return. Cerebrospinal fluid (CSF) studies are useful to confirm the diagnose of bacterial infections, but are less effective in distinguishing between viral infections and autoimmune processes (13, 17). Magnetic resonance imaging (MRI) can provide evidence of CNS inflammation, but not the underlying cause of the inflammation (18).…”

Section: Introductionmentioning

confidence: 99%

The Different Clinical Features Between Autoimmune and Infectious Status Epilepticus

Lin

et al. 2019

Front. Neurol.

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Objective: The prognosis of status epilepticus (SE) is highly related to the underlying etiology. Inflammation of the central nervous system (CNS), including infection and autoimmune encephalitis, is one of the treatable conditions causing SE. The initial presentation of infectious and autoimmune CNS disorders can be quite similar, which may be difficult to differentiate at the beginning. However, treatment for these entities can be quite different. In this study, we aim to identify the differences in clinical features among patients with infectious and autoimmune SE, which could help the clinicians to select initial investigation and ensuing therapies that may improve overall outcomes. Methods: This was a retrospective study that included 501 patients with SE within a period of 10.5-years. Patients with inflammatory etiology were collected and separated into infectious and autoimmune SE. The symptoms at onset, SE semiology, status epilepticus severity score, and END-IT score at admission, treatment for SE, and outcome (modified Rankin Scale) on discharge and last follow-up were recorded. Data on the first cerebrospinal fluid, electroencephalography, and magnetic resonance imaging were also collected. Results: Forty-six (9.2%) of the 501 patients had SE with inflammatory etiology. Twenty-five (5%) patients were autoimmune SE and 21 (4.2%) were infectious SE. Patients with autoimmune SE have younger age and female predominance. As for clinical presentations, psychosis, non-convulsive SE, and super refractory SE were more common in patients with autoimmune SE. Nevertheless, the prognosis showed no difference between the two groups. Conclusion: The different initial clinical presentations and patient characteristics may provide some clues about the underlying etiology of SE. When inflammatory etiology is suspected in patients with SE, younger age, female sex, psychosis, non-convulsive SE, and super refractory SE are clinical features that suggest an autoimmune etiology.

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Bacterial Infections of the Central Nervous System

Cited by 48 publications

References 27 publications

Cell Biology of Intracellular Adaptation of Mycobacterium leprae in the Peripheral Nervous System

Cell Biology of Intracellular Adaptation of Mycobacterium leprae in the Peripheral Nervous System

Pediatric meningitis due to Neisseria meningitidis, Streptococcus pneumoniae and Group B Streptococcus in Tijuana, Mexico: active/prospective surveillance, 2005–2018

The Different Clinical Features Between Autoimmune and Infectious Status Epilepticus

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