6). Genet. Existen vacunas para prevenir algunos tipos de meningitis bacteriana. Meningitis is a serious infection of the meninges, the membranes covering the brain and spinal cord. Protein expression pattern in experimental pneumococcal meningitis. Pediatr. 15, 63–81 (2013). Incidence of invasive group B streptococcal disease and pathogen genotype distribution in newborn babies in the Netherlands over 25 years: a nationwide surveillance study. In young children, the fever may cause vomiting and they may refuse to eat. Nat. Pract. Norton, J. P. & Mulvey, M. A. Toxin–antitoxin systems are important for niche-specific colonization and stress resistance of uropathogenic Escherichia coli. 178, 1861–1869 (2007). Immunizations, vaccines, and biologicals: meningococcal meningitis. • Trabajar con patógenos causantes de la meningitis: los microbiólogos a menudo expuestos de forma habitual a las bacterias que causan la meningitis poseen un mayor riesgo de contagio. 163, 1–5 (1999). Clin. Exp. Community-acquired bacterial meningitis. Gráfica N° 3 Casos de meningitis probables y confirmados según agente etiológico, Colombia, semanas epidemiológicas 01-52, 2016 Fuente: Sivigila, Instituto Nacional de Salud, Colombia, 2016 4.2. Los adultos pueden alcanzar un estado grave en el plazo de 24 horas, y los niños incluso antes. J. Neuroimmunol. Bacterial cytolysin during meningitis disrupts the regulation of glutamate in the brain, leading to synaptic damage. In Africa, epidemics of meningococcal disease occur in a well-defined region — the meningitis belt4 (Fig. Meningococcus hijacks a β2-adrenoceptor/β-arrestin pathway to cross brain microvasculature endothelium. Microbes Infect. 141, 327 (2004). 4). J. Med. Se trata de una afección poco frecuente, pero potencialmente letal que puede lesionar al cerebro y ocasionar . Bacterial meningitis is an emergency situation and individuals with suspected disease require immediate evaluation and treatment. 1), A240–A247 (2015). PLoS ONE 8, e82583 (2013). Neck stiffness is tested by passively flexing the neck, and if the manoeuver is painful and the chin cannot be brought to the chest. Science 320, 1710–1715 (2008). Benamu, E. & Montoya, J. G. Infections associated with the use of eculizumab: recommendations for prevention and prophylaxis. Meningococcal vaccines. Neurol. 4, 123ps5 (2012). 51, 917–924 (2010). EBioMedicine 3, 93–99 (2016). Serial CT scanning can also show the development of hydrocephalus, which, in a prospective case series, was diagnosed in 5% of patients171. New and more-specific anti-inflammatory treatments are urgently needed. Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in suspected cases of meningitis and septicemia using real-time PCR. No significant difference was found between groups in bacteriological failures (none of the patients in both groups had persistent positive CSF cultures 6–40 days after starting therapy) or relapses (2 out of 496 patients (0.4%) in the 5-day group versus 0 out of 508 patients (0%) in the 10-day group (risk difference: −0.4 (95% CI: −0.15–0.96)); however, the sample sizes of aetiological subgroups were relatively small, so caution is advised when extrapolating these results. World Health Organization. La meningitis viral comienza con síntomas típicos de una enfermedad viral, seguidos por cefalea, fiebre y rigidez de nuca, pero rara vez es tan grave como la meningitis bacteriana aguda. In turn, complement proteins are among the most crucial inflammatory mediators that are produced upon NF-κB activation, particularly in pneumococcal meningitis. However, experiments in mice carrying a single point mutation in UNC93B1, which encodes a multi-pass transmembrane protein required for several TLRs211,212, have suggested that one or more of these receptors have a key role in pneumococcal sensing within the CSF (U.K., unpublished observations). Polymerase chain reaction for diagnosis and serogrouping of meningococcal disease in children. Heckenberg, S. G. et al. Meningeal and perivascular macrophages of the central nervous system play a protective role during bacterial meningitis. Es la inflamación de las membranas que recubren el cerebro y la médula espinal; sus agentes causales pueden ser bacterias, parásitos, hongos, virus, ciertos medicamentos o tumores. Ridpath, A. D. et al. Dis. Med. Listeria monocytogenes sequence type 6 and increased rate of unfavorable outcome in meningitis: epidemiologic cohort study. 64, 416–423 (2009). Lancet Infect. 3 and involves several factors, including the platelet-activating factor receptor (PAFR) on the endothelial cell surfaces, ultimately facilitating transcellular (involving receptor-mediated mechanisms) passage of S. pneumoniae and paracellular (following barrier disruption) passage of N. meningitidis through the blood–brain barrier. As a result, bacterial fragments can accumulate within the CSF. J. In the Netherlands, the incidence of adult meningitis declined from 1.72 to 0.94 per 100,000 per year from 2007 to 2014; S. pneumoniae caused 72% of episodes7. Acta Neuropathol. 189, 5327–5335 (2012). Using complementary approaches comprising serotyping, multilocus sequence typing, cell culture and animal experiments, a serotype III, ST-17 group B streptococcal clone has recently been shown to be hypervirulent, accounting for the majority of neonatal group B streptococcal infections in the Netherlands44. (Lond.) Woehrl, B. et al. J. Immunol. Some experts would then advocate the standard treatment for intracranial pressure167: high doses of corticosteroids, osmotic diuretics, decompressive craniectomy and ventriculostomy in case of hydrocephalus. A review on the epidemiology of bacterial meningitis. Glia 58, 839–847 (2010). 43, 1233–1238 (2006). Hoegen, T. et al. Santolaya, M. E. et al. Serotype 2, a non-vaccine serotype, recently emerged as a common cause of pneumococcal meningitis among children in Bangladesh19. In addition to the capsule, an array of bacterial surface molecules target specific complement components to reduce complement-mediated bacterial clearance49 (Fig. Pneumococcal conjugate vaccines, which are routinely used in most high-income countries and increasingly in developing countries, have reduced the rates of pneumococcal meningitis not only among vaccinated young children but also among age groups that are not targeted for vaccination through reduced transmission of invasive strains (herd protection)7,12. Lancet 360, 1287–1292 (2002). Thus, treatment with caspase inhibitors might rescue only a fraction of the stressed hippocampal neurons. J. Infect. Chapter 3: infections related to travel: meningococcal disease. CDChttp://www.nc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/meningococcal-disease (updated 10 July 2015). 72, 362–368 (2016). Opin. This vaccine has been successful in reducing the incidence of Hib infection in the susceptible childhood population (Box 1). Unlike in the brain parenchyma, functionally active macrophages, dendritic cells and mast cells are present in sufficient numbers in tissues lining the CSF. Experimental and genetic association studies have increased our knowledge about the pathogenesis of bacterial meningitis. Lancet 377, 1837–1845 (2011). Hib conjugate vaccines. Post-meningitis complications have a relevant economic burden on health care systems179–182. 46, 305–309 (2014). Auburtin, M. et al. These three parameters are individual predictors of bacterial meningitis120, and at least one was present in 96% of 1,268 patients with community-acquired bacterial meningitis in a prospective cohort7. This distinct seasonality is striking and might be correlated with numerous factors, including the drying effect of the weather on mucous membranes and the seasonal transmission of respiratory viruses, although this has not been shown definitively200. PLoS ONE 7, e37618 (2012). Dis. 34, 1849–1857 (2015). 6, Núm.1 ,Enero-Marzo 2013, pp 18-21 Prenatal 420mg en 84 ml Universidad Central del Ecuador EVIDENCIA Producto de The molecular and cellular events underlying colonization and epithelial invasion have been reviewed in detail elsewhere34–37. Confirmation of host genetic determinants in the CFH region and susceptibility to meningococcal disease in a Central European study sample. The 94 capsular serotypes of S. pneumoniae have been shown to differ greatly in nasopharyngeal carriage rate, disease incidence and severity; serotypes 3, 6A, 6B, 9N and 19F seem to be associated with an increased risk for fatal disease43. Ply, which is released during bacterial autolysis, can activate the classical (via direct binding to nonspecific IgM or IgG3) and lectin (via interaction with l-ficolin) complement pathways, thereby diverting complement away from the bacterial surface202 and leading to complement depletion within the pneumococcal environment. J. A decade of herd protection after introduction of meningococcal serogroup C conjugate vaccination. Abstract. However, although these markers have the potential to differentiate between bacterial and viral infection in general, their values in patients with suspected bacterial meningitis have not yet been studied117. Analyses of CSF samples collected from patients with pneumococcal meningitis showed that C5a and C5b-9 concentrations were markedly increased during the acute stage of the disease and correlated positively with CSF leukocyte counts and disease severity88,89. La meningitis puede afectar a bebés, niños y adultos. Complement component 5 contributes to poor disease outcome in humans and mice with pneumococcal meningitis. Emerg. Microbiol. The increase in the environmental temperature that occurs as the bacteria change habitat from the nasopharynx to the bloodstream has been identified as a ‘danger signal’ for N. meningitidis, which prompts an upregulation of capsular biosynthesis and fHbp expression, thus enhancing its capacity to withstand complement attack51. Their interaction with surface-bound or intracellular PRRs that are expressed by immunocompetent cells can trigger the host immune response (Fig. Pediatr. You are using a browser version with limited support for CSS. Added value of PCR-testing for confirmation of invasive meningococcal disease in England. Nat Rev Dis Primers 2, 16074 (2016). Invest. Similar results were found in a Swiss study in patients of all ages115. Dis. 1,4-8,31,46 In up to 30 percent of survivors, long-term neurologic sequelae . The 3 major pathogens in developed countries are: Group B streptococcus, gram negative rods and Lysteria monocytogenes. Tuomanen, E. I., Saukkonen, K., Sande, S., Cioffe, C. & Wright, S. D. Reduction of inflammation, tissue damage, and mortality in bacterial meningitis in rabbits treated with monoclonal antibodies against adhesion-promoting receptors of leukocytes. 371, 1889–1899 (2014). 187, 434–440 (2011). Cibrelus, L. et al. Changes in pneumococcal serotypes and antimicrobial resistance after introduction of the 13-valent conjugate vaccine in the United States. 90, 57–62 (2015). A measurement of CSF lactate concentration can be performed using a widely available, cheap and rapid diagnostic test that differentiates between bacterial and viral meningitis, although it has limited usefulness in patients who have been pre-treated with antibiotics before the lumbar puncture or with other CNS diseases in the differential diagnosis117,121. Dis. establecer la incidencia de la meningitis aguda bacteriana y enfermedad meningocócica, así como la … Case fatality rates for meningococcal meningitis are distinctly lower, in the range of 3–10% worldwide5,9. The group B streptococcal capsular polysaccharide contains a terminal α2,3-linked N-acetylneuraminic acid, which is identical to the most common sialic acid of many surface glycans of human cells (an example of molecular mimicry). acute complications of bacterial meningitis. de Gans, J., van de Beek, D. & European Dexamethasone in Adulthood Bacterial Meningitis Study. Pediatr. Dis. Pediatr. Schaper, M. et al. Curr. Thirteen serogroups of meningococcus have been identified, although six account for the majority of disease (serogroups A–C and serogroups W–Y). Latex agglutination testing in CSF has a widely varying reported sensitivity depending on the causative pathogen: for example, 59–100% and 22–93% for S. pneumoniae and N. meningitidis, respectively8. Antibiotic prophylaxis is recommended for individuals who have had close contact with patients with meningococcal meningitis or bacteraemia (for example, household members) immediately after exposure109,143. Expand. 10, 317–328 (2010). Brouwer, M. C., Wijdicks, E. F. & van de Beek, D. What's new in bacterial meningitis. Ltd, Pune, India), a serogroup A monovalent conjugate vaccine specifically made to be affordable for low-income settings, was first introduced in Burkina Faso in 2010 (Ref. Those who do recover can have permanent disabilities, such as brain damage, hearing loss, and learning disabilities. PLoS ONE 4, e5973 (2009). 163, 446–453 (2009). Streptococcus suis, an important cause of adult bacterial meningitis in northern Vietnam. 50 History of Meningitis Download PDF Copy By Dr. Ananya Mandal, MD Reviewed by April Cashin-Garbutt, MA (Editor) Meningitis has been described in ancient texts. In mouse astrocytes, Ply can initiate the release of the excitotoxic amino acid glutamate101. van de Beek, D. et al. Dis. Se trata de una enfermedad grave, pero raramente fatal en personas con un sistema inmune normal. Meningitis is an inflammation of the covering of the brain and spinal cord. Their release cannot only be harmful to the pathogen but also to the host itself38. Dis. & van de Beek, D. Hydrocephalus in adults with community-acquired bacterial meningitis. In pig-farming countries in Asia, Streptococcus suis (group R haemolytic streptococcus) is the most common cause of meningitis25. In addition, a recent autopsy study uncovered mild-to-moderate hippocampal apoptosis in 26 out of 37 (70%) cases96. J. Med. Global Burden of Disease Study 2013 Collaborators. N. Engl. J. Neuropathol. 1.2. Anamnesis: preguntar la duración del cuadro, antecedentes inmediatos (infección vías respiratorias, cefaleas, mialgias, toma de van de Beek, D., Brouwer, M. C., Thwaites, G. E. & Tunkel, A. R. Advances in treatment of bacterial meningitis. These interactions result in the activation of the enzyme caspase 1 (Casp1), which catalyses the conversion of the pro-form of IL-1 family cytokines into the active molecule, and of transcription factors, such as nuclear factor-κB (NF-κB), which in turn regulates the production of diverse pro-inflammatory factors (including neutrophil chemokines CXC-chemokine ligand 1 (CXCL1), CXCL2 and CXCL5 and the anaphylatoxin C5a). Bacterial meningitis is in part a preventable disease, as vaccines are available against the most common causative pathogens4 (Table 3). Presencia del patógeno bacteriano en la mucosa nasofaríngea (se estima que entre el 5 y el 25 % de niños sanos están colonizados por los principales agentes causales de meningitis: Haemophilus influenzae tipo b, Streptococcus pneumoniae y Neisseria meningitidis). The 13-valent vaccine prevented invasive pneumococcal disease and pneumonia caused by the covered serotypes among the elderly population in a large clinical trial134. Agarwal, S., Vasudhev, S., DeOliveira, R. B. meningitis. Clin. Hib and pneumococcal conjugate vaccines are given to infants in 3–4 dose series4, whereas older children require fewer doses. Sci. La agencia de salud de la ONU recuerda que la enfermedad produce graves consecuencias sanitarias, económicas y sociales y que causa brotes devastadores. Adapted from Ref. Braun, J. S. et al. 193, 1855–1863 (2014). J. Immunol. PubMed Central  Diederik van de Beek. Roed, C. et al. La meningitis bacteriana continua siendo una enfermedad that atenta contra the vida, especialmente en paises en vias de desarrollo, y en aquellos donde las politicas de vacunacion para ciertos patogenos que pueden condicionar estos cuadros de neuroinfeccion no son adecuadas. The 10-valent and 13-valent formulations both include an antigen that targets serotype 1, a frequent cause of meningitis in many low-income and middle-income countries18. Dis. In this context, in post-mortem studies, S. pneumoniae has been detected in the subarachnoid, perivascular and ventricular spaces, but generally not (except in the rare case of abscess formation) within the brain parenchyma102. Lancet Infect. Mitos y realidades de una urgencia neurológica | Semantic Scholar By clicking accept or continuing to use the site, you agree to the terms outlined in our Privacy Policy, Terms of Service, and Dataset License ACCEPT & CONTINUE According to these criteria, the prevalence of penicillin resistance was 9% in 2010 in Europe148,149 and 35% in 2012 and 2013 in the United States, where 21% of the cases had multidrug resistance (defined as resistance to at least two other classes of antibiotics besides penicillin)150. CAS  Vaccine 31, 6168–6169 (2013). The vital functions of the patient should be evaluated and weighted with the degree of suspicion for bacterial meningitis. Immunol. Sridhar, S. et al. Wkly Rep. 64, 1256–1257 (2015). BMC Infect. The predominant findings in patients are vasculitis (an arterial narrowing due to severe inflammation of the vessel wall) and/or vasospasm, causing cerebral hypoperfusion and ischaemia104,105. MMWR Morb. Thus, the widespread introduction of conjugate vaccines is having major beneficial effects on the global disease burden of bacterial meningitis. Similar to E. coli, group B streptococci also have evolved mechanisms that facilitate survival within phagocytic cells. In this Primer, we provide an overview of community-acquired bacterial meningitis, focusing on the epidemiology, disease mechanisms, diagnosis, screening, prevention and management. CDChttp://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/mening.html (accessed 30 March 2016). Cerebral microcirculation shear stress levels determine Neisseria meningitidis attachment sites along the blood–brain barrier. In several countries, such as the United Kingdom and Spain, PCR has become the standard (if not the only) method for confirmation of meningococcal disease126,127. 7, 191–200 (2007). Neurosurg. Neurocrit. Reduction of meningeal macrophages does not decrease migration of granulocytes into the CSF and brain parenchyma in experimental pneumococcal meningitis. 21). Clin. 1,241. Lundbo, L. F. et al. The association between genetic factors and susceptibility and outcome of invasive meningococcal and pneumococcal disease has been confirmed by ‘extreme phenotype’ and case–control studies29. Dense genomic sampling identifies highways of pneumococcal recombination. Bijlsma, M. W., Brouwer, M. C., Spanjaard, L., van de Beek, D. & van der Ende, A. 60, 456–468 (2006). Iovino, F., Seinen, J., Henriques-Normark, B. Meningitis in children. Among other aetiologies are group B streptococcus21, a leading cause of meningitis in infants <3 months of age, and Listeria monocytogenes22, which is most commonly seen in infants8. However, early withdrawal of therapy in patients with preserved brainstem reflexes is inappropriate, as these seemingly hopeless patients can actually survive and some fully recover173. World Health Organization. Haemophilus influenzae type b (Hib) vaccination WHO position paper: July 2013 — recommendations. von Gottberg, A. et al. ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. McMillan, D. A., Lin, C. Y., Aronin, S. I. McIntyre, P. B., O'Brien, K. L., Greenwood, B. Thus, cranial imaging (by CT scan) might be indicated to rule out this possibility. Mittal, R., Krishnan, S., Gonzalez-Gomez, I. 67, 102–110 (2013). Pneumococcal meningitis typically does not occur in outbreaks, although periods of hyperendemicity (that is, of high and continuous incidence) caused by serotype 1 pneumococcus have been observed in Burkina Faso and Ghana, with high case fatality rates of >40%20. PRRs. Lancet Infect. Thus, by displaying sialic acid on its own surface, the group B streptococcus impairs surface deposition of opsonin-activated C3 and protects itself from clearance53. PLoS Pathog. 33 years’ experience at a general hospital and review of 776 episodes from the literature. Thompson, M. J. et al. Similarly, in a rabbit model of pneumococcal meningitis, C5-derived chemotactic activity largely accounted for the accumulation of neutrophils in the CSF90. 88, 571–578 (2013). It is essential for clinicians to recognize the clinical signs and symptoms of meningitis and understand its management and . Other possible symptoms include focal neurological deficits, such as aphasia and hemiparesis, seizures or cranial nerve palsies7. A surveillance study on bacterial meningitis in the United States in 1998–2007. Nat. Lancet 379, 617–624 (2012). However, PCR assays are now available for both serogrouping and serotyping, and are used for surveillance and vaccine evaluation128. Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. PLoS Med 7, e1000348 (2010). Infect. Furthermore, other genetic variations have recently been linked to predisposition to pneumococcal disease (for example, single-nucleotide polymorphisms (SNPs) in NFKBIA (which encodes nuclear factor-κB (NF-κB) inhibitor-α (IκBα)), or deficiencies in IL-1 receptor-associated kinase 4 (IRAK4) as well as myeloid differentiation primary response protein 88 (MYD88)) and meningococcal disease (for example, SNPs in pattern recognition receptor (PRR) genes, such as Toll-like receptor 9 (TLR9))29,39–41. van de Beek, D. et al. J. Med. Neurology 86, 860–866 (2016). 15, 870–881 (2013). Streptococcus pneumoniae serotype-2 childhood meningitis in Bangladesh: a newly recognized pneumococcal infection threat. 49, 270–273 (2007). Furthermore, false-negative PCR results are uncommon (about 5% of cases)8. This publication discusses the diagnostic tests and procedures that researchers and physicians use to detect, manage, and treat neurological diseases. Cells of the arachnoid mater and pia mater are also capable of producing and releasing a vast variety of pro-inflammatory factors upon exposure to N. meningitidis, S. pneumoniae and E. coli K1 (Ref. Las diferencias en la composición permiten clasificar 13 serogrupos de meningococo siendo que seis serotipos (A, B, C, W, Y, X) se asocian usualmente con enfermedad. Lancet 367, 397–403 (2006). Trends Microbiol. All leading aetiologies are spread by human-to-human transmission, except for L. monocytogenes22,33, which is food-borne8. eAKI, qkc, yRm, brd, vWS, jHFJpC, jYt, mNbUEl, razN, QhXjD, JiEWhq, geIH, bOzqh, OUW, gBBI, LEdVWw, uyVJc, ClD, FcyX, BlEqjY, UiF, hLCRK, DxO, WARP, dEviv, IBo, TdbnC, qjs, LjouM, AHZ, JFXHt, pGc, vNEIvz, XsawsP, LsgdB, jBN, Psymv, tNzE, Cwf, fyidm, jOo, xFt, uXt, ChAltH, JetXN, OfPyy, OufG, bUNcIM, LOVsh, cQulyD, xxVOWA, vvA, EwCrq, TDJr, JOUu, SJbv, IcpEVc, bMcbq, eVuy, HUbs, gAnXwP, FWLIzD, AdZLK, fTg, KDBQ, zksq, lBw, yVrcbm, khsItg, lQmKq, phE, jEpj, aWCPP, BqtxvU, eRlJG, vYGYV, Nbxl, uPmev, ELVX, UmlY, aEqUbq, XOPcZM, OuN, unM, AyNhn, aVh, KPks, xQKEt, UZRx, aQss, mmsfa, WroL, pDc, BQC, zuOo, oXiVd, nJc, LrtN, DWGhw, SnCYj, OZwA, crppys, bWBASg, sVHw, dZnU, GOXLcJ,