Streptococcus suis, an Important Cause of Adult Bacterial Meningitis in Northern Vietnam

Abstract

Background Streptococcus suis can cause severe systemic infection in adults exposed to infected pigs or after consumption of undercooked pig products. S. suis is often misdiagnosed, due to lack of awareness and improper testing. Here we report the first fifty cases diagnosed with S. suis infection in northern Viet Nam.Methodology/Principal FindingsIn 2007, diagnostics for S. suis were set up at a national hospital in Hanoi. That year there were 43 S. suis positive cerebrospinal fluid samples, of which S. suis could be cultured in 32 cases and 11 cases were only positive by PCR. Seven patients were blood culture positive for S. suis but CSF culture and PCR negative; making a total of 50 patients with laboratory confirmed S. suis infection in 2007. The number of S. suis cases peaked during the warmer months.Conclusions/Significance S. suis was commonly diagnosed as a cause of bacterial meningitis in adults in northern Viet Nam. In countries where there is intense and widespread exposure of humans to pigs, S. suis can be an important human pathogen.

The Minor Pilin Subunit Sgp2 Is Necessary for Assembly of the Pilus Encoded by the srtG Cluster of Streptococcus suis

“…Streptococcus suis is a Gram-positive coccus responsible for a wide range of diseases in pigs, including meningitis, septicemia, endocarditis, and sudden death (14,37). This bacterium can also affect humans in close contact with diseased pigs or swine products (1,7,43,49,51). Four putative pilus gene clusters, named the srtBCD, srtE, srtF, and srtG clusters, have so far been identified in S. suis (9, 40).…”

“…This bacterium can also affect humans in close contact with diseased pigs or swine products (1,7,43,49,51). Four putative pilus gene clusters, named the srtBCD, srtE, srtF, and srtG clusters, have so far been identified in S. suis (9,40).…”

Stimulating the development of national Streptococcus suis guidelines in Viet Nam through a strategic research partnership

“…Between January and May 2007, 19 cases of S. suis meningitis were detected and 50 cases were detected for the entire year (Fig. 1) 9 Of the 50 patients with S. suis, 26 (52%) recovered completely, 21 (42%) recovered with sequelae and 3 patients died. Hearing loss was the most common sequela (38%).…”

“…6,7 However, it was not until a large outbreak in Sichuan province, China in 2005 that interest in this pathogen grew 8 and S. suis is now increasingly recognized as a major cause of bacterial meningitis in south-east Asia. 1,2,4,9 Despite this increased interest, it is probable that the burden of S. suis is considerably under-estimated since clinical awareness is low and many smaller hospitals do not possess a microbiology service. Even in hospitals with a microbiology service, infection may be misdiagnosed as a viridans group streptococcus or Enterococcus.…”

Non-Foodborne Swine Zoonotic Diseases

“…S. suis was detected in 151 (33.6 %), from total of 450 patients with suspected bacterial meningitis in one prospective study [35]. Serotype 2 was the most commonly detected organism in Viet Nam, and is responsible for acute meningitis in adults [36]. Human S. suis cases are most often reported from countries where density of pigs is high (Figure1) and where pig-rearing is common practice [28].…”