Bacterial Meningitis in Malawian Adults: Pneumococcal Disease is Common, Severe, and Seasonal

Gordon, Stephen B.; Walsh, Amanda L.; Chaponda, Mas; Gordon, Melita A.; Soko, D.; Mbwvinji, Milton; Molyneux, Malcolm E.; Read, Robert C.

doi:10.1086/313910

Cited by 110 publications

(91 citation statements)

References 16 publications

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“…We did not isolate Neisseria meningitidis in this study; that could be explained by the fact that, bacteria are mainly involved in the cases of epidemics of meningitis in sahelian region of Cameroon. C. neoformans was the only microbe responsible of fungal meningitis, and in 40% of the cases of meningeal irritation syndrome from patients with AIDS; these results are in accordance with those of previous studies (Gordon et al, 2000;Roos, 2003;Millogo et al, 2004;Békondi et al, 2006), since Cryptococcal meningitis has been described as the most common life-threatening opportunistic fungal infection in patients with immune-compromised status.…”

Section: Discussionsupporting

confidence: 91%

Bacterial and fungal etiologies of meningeal irritation syndrome in an emergency department

Claudine¹,

Larissa²,

Dieudonne³

et al. 2017

Afr. J. Microbiol. Res.

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Meningeal irritation syndrome denotes to a range symptoms that require emergency management. Clinically, it is an expression of an irritation of the meninges combining with headache, fever, neck stiffness, altered consciousness and vomiting. The aim of this prospective study was to contribute to the management of medical emergencies. Cerebrospinal fluid (CSF) samples recovered from patients presenting signs of meningeal irritation syndrome were submitted to bacteriological, biochemical and fungal analyses. 2656 patients were received during the study period with 47 (1.8%), which had signs of meningeal irritation syndrome. 17% of cases were bacterial meningitis while 10.6% were fungal meningitis. Microbes isolated were Streptococcus pneumoniae, Streptococcus agalactiae, Haemophilus influenza and Cryptococcus neoformans. All bacteria were found to be sensitive to amoxicillin + clavulanic acid, gentamycin, chloramphenicol and ceftriaxone, and resistant to penicillin G, ampicillin and cotrimoxazol. All cases of cryptococcal meningitis were HIV (+) subjects. Other causes of meningeal irritation syndrome were HIV-related encephalitis (19.2%) and malaria (19.2%). Bacterial and fungal meningitis accounted for about 1/3 of the cases of meningeal irritation syndrome. The bacteria isolated presented a satisfactory sensitivity profile to the usual antibiotics. Although the prevalence of meningeal irritation syndrome appears to be low, it would be interesting to pay particular attention to it given the high representation of immunocompromised patients.

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Section: Discussionsupporting

confidence: 91%

Bacterial and fungal etiologies of meningeal irritation syndrome in an emergency department

Claudine¹,

Larissa²,

Dieudonne³

et al. 2017

Afr. J. Microbiol. Res.

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“…Highly active antiretroviral therapy (HAART) reduces this risk but leaves it 35 times higher than that for meningitis patients without HIV infection (34,130,143). The increased risk of pneumococcal infections of HIV-infected patients has a profound impact in low-resource countries, where up to 95% of patients with pneumococcal meningitis have been reported to be HIV positive (128,129,176,198,213). The clinical presentations of HIV-positive and HIV-negative patients with bacterial meningitis are similar (198,213), although one study reported a higher seizure rate among HIV-positive patients (236).…”

Section: Immunocompromised Statementioning

confidence: 99%

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

2010

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SUMMARY The epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations at risk to ascertain public health measures and ensure appropriate management. In this review, we describe the changing epidemiology of bacterial meningitis in the United States and throughout the world by reviewing the global changes in etiological agents followed by specific microorganism data on the impact of the development and widespread use of conjugate vaccines. We provide recommendations for empirical antimicrobial and adjunctive treatments for clinical subgroups and review available laboratory methods in making the etiological diagnosis of bacterial meningitis. Finally, we summarize risk factors, clinical features, and microbiological diagnostics for the specific bacteria causing this disease.

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“…Although cases of cryptococcosis in AIDS patients have decreased in developed countries due to the introduction of highly active antiretroviral therapy in the mid1990s, this disease remains responsible for up to 30% of the attributable mortality in AIDS patients in regions where highly active antiretroviral therapy is not readily available, such as Southeast Asia and Africa (7,9,12,24,25,27,28,37).…”

mentioning

confidence: 99%

Impact of Mating Type, Serotype, and Ploidy on the Virulence of Cryptococcus neoformans

et al. 2008

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Hybridization with polyploidization is a significant biological force driving evolution. The effect of combining two distinct genomes in one organism on the virulence potential of pathogenic fungi is not clear. Cryptococcus neoformans, the most common cause of fungal infection of the central nervous system, has a bipolar mating system with a and ␣ mating types and occurs as A (haploid), D (haploid), and AD hybrid (mostly diploid) serotypes. Diploid AD hybrids are derived either from a-␣ mating or from unisexual mating between haploid cells. The precise contributions of increased ploidy, the effect of hybridization between serotypes A and D, and the combination of mating types to the virulence potential of AD hybrids have remained elusive. By using in vitro and in vivo characterization of laboratory-constructed isogenic diploids and AD hybrids with all possible mating type combinations in defined genetic backgrounds, we found that higher ploidy has a minor negative effect on virulence in a murine inhalation model of cryptococcosis. The presence of both mating types a and ␣ in AD hybrids did not affect the virulence potential, irrespective of the serotype origin. Interestingly, AD hybrids with only one mating type behaved differently, with the virulence of ␣AD␣ strains similar to that of other hybrids, while aADa hybrids displayed significantly lower virulence due to negative epistatic interactions between the Aa and Da alleles of the mating type locus. This study provides insights into the impact of ploidy, mating type, and serotype on virulence and the impact of hybridization on the fitness and virulence of a eukaryotic microbial pathogen.

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Bacterial Meningitis in Malawian Adults: Pneumococcal Disease is Common, Severe, and Seasonal

Cited by 110 publications

References 16 publications

Bacterial and fungal etiologies of meningeal irritation syndrome in an emergency department

Bacterial and fungal etiologies of meningeal irritation syndrome in an emergency department

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

Impact of Mating Type, Serotype, and Ploidy on the Virulence of Cryptococcus neoformans

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