MENINGITIS

1.                  Auburtin M, Wolff M, Charpentier J, Varon E, Le Tulzo Y, Girault C, Mohammedi I, Renard B, Mourvillier B, Bruneel F, Ricard JD, Timsit JF.  Detrimental role of delayed antibiotic administration and penicillin-nonsusceptible strains in adult intensive care unit patients with pneumococcal meningitis: the PNEUMOREA prospective multicenter study. Crit Care Med. 2006 Nov;34(11):2758-65. 

From the Service de Reanimation Medicale et des Maladies Infectieuses, Hopital Bichat-Claude-Bernard, AP-HP, Paris, France.

OBJECTIVE: To identify factors associated with mortality and morbidity among adults admitted to intensive care units (ICUs) for pneumococcal meningitis, particularly the impact of delayed antibiotic administration. DESIGN: We conducted a prospective, multicenter, observational study of 156 consecutive adults hospitalized for pneumococcal meningitis. We analyzed parameters associated with 3-month survival. SETTING: Fifty-six medical and medical-surgical ICUs in France. INTERVENTION: None. RESULTS: Of the 148 strains isolated, 56 (38%) were nonsusceptible to penicillin G. At 3 months after ICU admission, the mortality rate was 33% (51/156), and 34% of survivors (36/105) had neurologic sequelae. Multivariate analysis identified three variables as independently associated with 3-month mortality: Simplified Acute Physiology Score II (odds ration [OR], 1.12; 95% confidence interval [CI], 1.072-1.153; p = .002); isolation of a nonsusceptible strain (OR, 6.83; 95% CI, 2.94-20.8; p < 10(-4)), and an interval of >3 hrs between hospital admission and administration of antibiotics (OR, 14.12; 95% CI, 3.93-50.9; p < 10(-4)). In contrast, a cerebrospinal fluid leukocyte count >10(3) cells/microL had a protective effect (OR, 0.30; 95% CI, 0.10-0.944; p = 0.04). CONCLUSIONS: Independent of severity at the time of ICU admission, isolation of penicillin-nonsusceptible strains and a delay in antibiotic treatment following admission were predictors of mortality among patients with pneumococcal meningitis.

2.                  Shalabi M, Whitley RJ. Recurrent benign lymphocytic meningitis. Clin Infect Dis. 2006 Nov 1;43(9):1194-7.

Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35294, USA.

Recurrent benign lymphocytic meningitis is a recurring, typically innocuous, painful form of aseptic meningitis. This syndrome is associated with transient neurological symptoms in one-half of afflicted patients. The causative agent is usually herpes simplex virus type 2, which can be confirmed by detection of viral DNA in the cerebrospinal fluid using polymerase chain reaction. Clinical disease resolves spontaneously; however, acyclovir, valacyclovir, and famciclovir have been administered to some patients for both episodic therapy and suppression of recurrences. This therapy is thought to be beneficial, although there is no controlled trial data to support efficacy and safety.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

15459.  Belorgey L, Lalani I, Zakaria A.  Ischemic stroke in the setting of tuberculous meningitis. J Neuroimaging. 2006 Oct;16(4):364-6. 

15460.  Nagafuchi M, Nagafuchi Y, Sato R, Imaizumi T, Ayabe M, Shoji H, Ichiyama T. Adult meningism and viral meningitis, 1997-2004: clinical data and cerebrospinal fluid cytokines. Intern Med. 2006;45(21):1209-12.

15461.  Nolte FS. Case studies in cost effectiveness of molecular diagnostics for infectious diseases: pulmonary tuberculosis, enteroviral meningitis, and BK virus nephropathy. Clin Infect Dis. 2006 Dec 1;43(11):1463-7.

15462.  Rayamajhi A, Singh R, Prasad R, Khanal B, Singhi S. Clinico-laboratory profile and outcome of Japanese encephalitis in Nepali children. Ann Trop Paediatr. 2006 Dec;26(4):293-301. 

15463.  Saha SK, Baqui AH, El Areefin S, Qazi S, Billal DS, Islam M, Roy E, Ruhulamin M, Black RE, Santosham M. Detection of antigenuria for diagnosis of invasive Haemophilus influenzae type b disease. Ann Trop Paediatr. 2006 Dec;26(4):329-36. 

15464.  Zerr DM, Frenkel LM, Huang ML, Rhoads M, Nguy L, Del Beccaro MA, Corey L.   Polymerase chain reaction diagnosis of primary human herpesvirus-6 infection in the acute care setting. J Pediatr. 2006 Oct;149(4):480-5. 

Pathogenesis:

15465.  Mogensen TH, Paludan SR, Kilian M, Ostergaard L.  Two neisseria meningitidis strains with different ability to stimulate toll-like receptor 4 through the MyD88-independent pathway. Scand J Immunol. 2006 Dec;64(6):646-54. 

Vaccines: 

15466.  Bonnet MC, Dutta A, Weinberger C, Plotkin SA.  Mumps vaccine virus strains and aseptic meningitis. Vaccine. 2006 Nov 30;24(49-50):7037-45.

15467.  Brenneman G, Rhoades E, Chilton L. Forty years in partnership: the American Academy of Pediatrics and the Indian Health Service. Pediatrics. 2006 Oct;118(4):e1257-63. 

15468.  Granerod J, Davison KL, Ramsay ME, Crowcroft NS.  Investigating the aetiology of and evaluating the impact of the Men C vaccination programme on probable meningococcal disease in England and Wales. Epidemiol Infect. 2006 Oct;134(5):1037-46.

15469.  Kelly DF, Snape MD, Cutterbuck EA, Green S, Snowden C, Diggle L, Yu LM, Borkowski A, Moxon ER, Pollard AJ. CRM197-conjugated serogroup C meningococcal capsular polysaccharide, but not the native polysaccharide, induces persistent antigen-specific memory B cells. Blood. 2006 Oct 15;108(8):2642-7.

15470.  Moore HC, Lehmann D.  Decline in meningitis admissions in young children: vaccines make a difference. Med J Aust. 2006 Oct 2;185(7):404.

15471.  Saha SK, Baqui AH, El Areefin S, Qazi S, Billal DS, Islam M, Roy E, Ruhulamin M, Black RE, Santosham M. Detection of antigenuria for diagnosis of invasive Haemophilus influenzae type b disease.Ann Trop Paediatr. 2006 Dec;26(4):329-36. 

15472.  Savory EC, Cuevas LE, Yassin MA, Hart CA, Molesworth AM, Thomson MC. Evaluation of the meningitis epidemics risk model in Africa. Epidemiol Infect. 2006 Oct;134(5):1047-51.

Therapy:

15473.  Al Khorasani A, Banajeh S.  Bacterial profile and clinical outcome of childhood meningitis in rural Yemen: a 2-year hospital-based study. J Infect. 2006 Oct;53(4):228-34.

15474.  Caws M, Thwaites G, Stepniewska K, Nguyen TN, Nguyen TH, Nguyen TP, Mai NT, Phan MD, Tran HL, Tran TH, van Soolingen D, Kremer K, Nguyen VV, Nguyen TC, Farrar J.   Beijing genotype of Mycobacterium tuberculosis is significantly associated with human immunodeficiency virus infection and multidrug resistance in cases of tuberculous meningitis. J Clin Microbiol. 2006 Nov;44(11):3934-9.

15475.  Fisk BA, Jackson WL Jr. Outcomes following pneumococcal meningitis: room for improvement remains expansive. Crit Care Med. 2006 Nov;34(11):2853-5.

15476.  Jubelt B.  Dexamethasone for the treatment of tuberculous meningitis in adolescents and  adults. Curr Neurol Neurosci Rep. 2006 Nov;6(6):451-2.

15477.  Ricard JD, Wolff M, Lacherade JC, Mourvillier B, Hidri N, Barnaud G, Chevrel G, Bouadma L, Dreyfuss D. Levels of vancomycin in cerebrospinal fluid of adult patients receiving adjunctive corticosteroids to treat pneumococcal meningitis: a prospective multicenter observational study. Clin Infect Dis. 2007 Jan 15;44(2):250-5.

15478.  Weisfelt M, van de Beek D, Spanjaard L, Reitsma JB, de Gans J.  Community-acquired bacterial meningitis in older people. J Am Geriatr Soc. 2006 Oct;54(10):1500-7. 

15479.  Weisfelt M, Hoogman M, van de Beek D, de Gans J, Dreschler WA, Schmand BA.  Dexamethasone and long-term outcome in adults with bacterial meningitis. Ann Neurol. 2006 Oct;60(4):456-68.