Serratia marcescens meningitis: Epidemiology, prognostic factors and treatment outcomes

Wu, Yen-Mu; Hsu, Po-Chang; Yang, Chien-Chang; Chang, Hsien‐Kun; Ye, Jung-Jr; Huang, Ching-Tai; Lee, Ming-Hsun

doi:10.1016/j.jmii.2012.07.006

Cited by 25 publications

(19 citation statements)

References 30 publications

(24 reference statements)

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“…The value of CSF lactate levels for predicting the outcome of BM is still debatable. In this study, in a univariate analysis, the CSF lactate concentration in the first CSF sample did not discriminate the negative-outcome from the positive-outcome group and was not useful for predicting outcome, in agreement with previous reports 14,18,19 but in contrast to results from several other studies 9,10,11,12,13 . In the present study, the CSF lactate levels of the last sample were higher in the negative-outcome than in the positive-outcome group, corroborating the findings of a previous study 14 .…”

Section: Discussionsupporting

confidence: 87%

“…Experimental animal studies have shown that elevated CSF lactate levels persisting after appropriate antibiotic treatment are associated with increased morbidity and mortality, and may facilitate prognostic prediction 8 . Several studies showed that CSF lactate levels were significantly different in clinical samples obtained from patients with a positive and a negative prognosis 9,10,11,12,13,14,15 .…”

mentioning

confidence: 99%

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Comparison of cerebrospinal fluid lactate with physical, cytological, and other biochemical characteristics as prognostic factors in acute bacterial meningitis

Almeida

Barros

Petterle

et al. 2019

Arq. Neuro-Psiquiatr.

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Bacterial meningitis (BM) is associated with a high morbidity and mortality. Cerebrospinal fluid (CSF) lactate may be used as a prognostic marker of this condition. We hypothesized that CSF lactate levels would remain elevated in participants who died of acute BM compared with those who recovered from this disease. Objective: To evaluate the potential use of lactate and other CSF biomarkers as prognostic markers of acute BM outcome. Methods: This retrospective, longitudinal study evaluated dynamic CSF biomarkers in 223 CSF samples from 49 patients who fulfilled the inclusion criteria of acute BM, with bacteria identified by CSF culturing. The participants were grouped according to outcome: death (n = 9; 18.37%) and survival (n = 40; 81.63%). All participants received appropriate antibiotic treatment. Results: In the logistic regression model, lactate concentration in the final CSF sample, xanthochromia, and CSF glucose variation between the first and last CSF samples were predictors of a poor outcome (death). In contrast, decrease in CSF white blood cell count and CSF percentage of neutrophils, increase in the percentage of lymphocytes, and normalization of the CSF lactate concentration in the last CSF sample were predictors of a good prognosis. Conclusion: The study confirmed the initial hypothesis. The longitudinal analysis of CSF lactate is an important predictor of prognosis in acute BM.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Comparison of cerebrospinal fluid lactate with physical, cytological, and other biochemical characteristics as prognostic factors in acute bacterial meningitis

Almeida

Barros

Petterle

et al. 2019

Arq. Neuro-Psiquiatr.

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“…S. marcescens , as a typical opportunist and adaptable pathogen, is frequently isolated from polymicrobial infections in patients suffering from diseases such as pneumonia, meningitis, or urinary tract infections. Mixed bacterial populations include recalcitrant multiresistant Acinetobacter species, among other pathogens that can be Serratia cohabitants or contenders in the infected host ( 36 – 38 ).…”

Section: Discussionmentioning

confidence: 99%

A Transcriptional Regulatory Mechanism Finely Tunes the Firing of Type VI Secretion System in Response to Bacterial Enemies

Lazzaro

Feldman

2017

mBio

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The ability to detect and measure danger from an environmental signal is paramount for bacteria to respond accordingly, deploying strategies that halt or counteract potential cellular injury and maximize survival chances. Type VI secretion systems (T6SSs) are complex bacterial contractile nanomachines able to target toxic effectors into neighboring bacteria competing for the same colonization niche. Previous studies support the concept that either T6SSs are constitutively active or they fire effectors in response to various stimuli, such as high bacterial density, cell-cell contact, nutrient depletion, or components from dead sibling cells. For Serratia marcescens, it has been proposed that its T6SS is stochastically expressed, with no distinction between harmless or aggressive competitors. In contrast, we demonstrate that the Rcs regulatory system is responsible for finely tuning Serratia T6SS expression levels, behaving as a transcriptional rheostat. When confronted with harmless bacteria, basal T6SS expression levels suffice for Serratia to eliminate the competitor. A moderate T6SS upregulation is triggered when, according to the aggressor-prey ratio, an unbalanced interplay between homologous and heterologous effectors and immunity proteins takes place. Higher T6SS expression levels are achieved when Serratia is challenged by a contender like Acinetobacter, which indiscriminately fires heterologous effectors able to exert lethal cellular harm, threatening the survival of the Serratia population. We also demonstrate that Serratia’s RcsB-dependent T6SS regulatory mechanism responds not to general stress signals but to the action of specific effectors from competitors, displaying an exquisite strategy to weigh risks and keep the balance between energy expenditure and fitness costs.

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“…Gram-negative aerobic bacteria, such as Klebsiella pneumoniae, Serratia marcescens, Salmonella spp., and Pseudomonas aeruginosa, can occasionally be responsible for meningitis in certain patient groups, including infants and patients with head injuries or those undergoing postneurosurgical procedures or immunosuppression (31,47,48). M. tuberculosis is a common cause of chronic or subacute meningitis (49) and is associated with nonspecific symptoms and an absence of neck stiffness during early disease (50).…”

Section: Meningitismentioning

confidence: 99%

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

et al. 2014

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SUMMARY The brain is well protected against microbial invasion by cellular barriers, such as the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). In addition, cells within the central nervous system (CNS) are capable of producing an immune response against invading pathogens. Nonetheless, a range of pathogenic microbes make their way to the CNS, and the resulting infections can cause significant morbidity and mortality. Bacteria, amoebae, fungi, and viruses are capable of CNS invasion, with the latter using axonal transport as a common route of infection. In this review, we compare the mechanisms by which bacterial pathogens reach the CNS and infect the brain. In particular, we focus on recent data regarding mechanisms of bacterial translocation from the nasal mucosa to the brain, which represents a little explored pathway of bacterial invasion but has been proposed as being particularly important in explaining how infection with Burkholderia pseudomallei can result in melioidosis encephalomyelitis.

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Serratia marcescens meningitis: Epidemiology, prognostic factors and treatment outcomes

Cited by 25 publications

References 30 publications

Comparison of cerebrospinal fluid lactate with physical, cytological, and other biochemical characteristics as prognostic factors in acute bacterial meningitis

Comparison of cerebrospinal fluid lactate with physical, cytological, and other biochemical characteristics as prognostic factors in acute bacterial meningitis

A Transcriptional Regulatory Mechanism Finely Tunes the Firing of Type VI Secretion System in Response to Bacterial Enemies

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

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