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Meningitis por Streptococcus suis
Geffner Sclarsky,D. E.; Moreno Mu?oz,R.; Campillo Alpera,Ma.S.; Pardo Serrano,F.J.; Gómez Gómez,A.; Martínez-Lozano,Ma.D.;
Anales de Medicina Interna , 2001, DOI: 10.4321/S0212-71992001000600007
Abstract: human infection by streptococcus suis (s. suis) is a zoonosis, with a known occupational risk and clinical presentation mainly as a purulent meningitis with low mortality and frequent hearing loss and ataxia sequela. less than 150 human cases have been reported since original one thirty years ago. there is a geographical distribution most patients living in northen europe and south asia. s. suis disease in human has been reported in two patients in spain the last years. we present two patients with s. suis meningitis, both were men with occupation related by pork meet, and good outcome. they come at our hospital in a lapse of one month. both had neurosensorial hearing loss and walking ataxia. one patient had peripheral facial paralysis and diplopia because of paresia of contralateral sixth nerve, with complete resolution at three months.the rare presentation of s. suis meningitis in our country must not forget us to record the working risk at anamnesis.
Streptococcus suis, an Important Cause of Adult Bacterial Meningitis in Northern Vietnam  [PDF]
Heiman F. L. Wertheim, Huyen Nguyen Nguyen, Walter Taylor, Trinh Thi Minh Lien, Hoa Thi Ngo, Thai Quoc Nguyen, Bich Ngoc Thi Nguyen, Ha Hong Nguyen, Ha Minh Nguyen, Cap Trung Nguyen, Trinh Tuyet Dao, Trung Vu Nguyen, Annette Fox, Jeremy Farrar, Constance Schultsz, Hien Duc Nguyen, Kinh Van Nguyen, Peter Horby
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0005973
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 Findings In 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.
Risk Factors of Streptococcus suis Infection in Vietnam. A Case-Control Study  [PDF]
Dang Trung Nghia Ho,Thi Phuong Tu Le,Marcel Wolbers,Quang Thai Cao,Van Minh Hoang Nguyen,Vu Thieu Nga Tran,Thi Phuong Thao Le,Hoan Phu Nguyen,Thi Hong Chau Tran,Xuan Sinh Dinh,Song Diep To,Thi Thanh Hang Hoang,Truong Hoang,James Campbell,Van Vinh Chau Nguyen,Tran Chinh Nguyen,Van Dung Nguyen,Thi Hoa Ngo,Brian G. Spratt,Tinh Hien Tran,Jeremy Farrar,Constance Schultsz
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0017604
Abstract: Streptococcus suis infection, an emerging zoonosis, is an increasing public health problem across South East Asia and the most common cause of acute bacterial meningitis in adults in Vietnam. Little is known of the risk factors underlying the disease.
Meningitis por Streptococcus suis en un paciente inmunocompetente Streptococcus suis meningitis in an immunocompetent patient  [cached]
A. Nagel,V. Manias,N. Busquets,S. Sniadowsky
Revista argentina de microbiolog?-a , 2008,
Abstract: Se describe un caso de meningitis por Streptococcus suis en un paciente inmunocompetente. Presentaba astenia, debilidad generalizada, fiebre (39 °C), vómitos, deterioro del sensorio y desorientación témporo-espacial. Los cultivos de sangre (2/2) y de líquido cefalorraquídeo fueron positivos. La identificación preliminar se realizó utilizando las pruebas bioquímicas convencionales y fue completada en el Servicio Bacteriología Especial del INEI-ANLIS "Dr. Carlos G. Malbrán". Se comenzó el tratamiento con ampicilina y ceftriaxona. El microorganismo aislado demostró sensibilidad a ampicilina, cefotaxima y vancomicina. El paciente evolucionó favorablemente, pero se comprobó leve hipoacusia. Reingresó a los 4 meses con marcha atáxica, anacusia en oído izquierdo e hipoacusia en oído derecho. Continúa con seguimiento neurológico y audiométrico. Retrospectivamente se constató el contacto del paciente con cerdos. Se destaca la importancia de la anamnesis para alertar la sospecha de este agente etiológico en meningitis y bacteriemias. A case of Streptococcus suis meningitis is described in an immunocompetent patient presenting asthenia, general weakness, fever, vomiting, sensory deterioration and temporospatial disorder. The cerebrospinal fluid and two blood cultures (2/2 bottles) were positive. The isolate was preliminary identified by conventional biochemical tests, and the identification was completed at the Special Bacteriology Service of INEI-ANLIS "Dr. Carlos G. Malbrán". Ampicillin and ceftriaxone treatment was initiated. The isolate was susceptible to ampicillin, cefotaxime and vancomycin. The patient experienced a good outcome but suffered hearing loss. However, after four months he returned with walking ataxia, deafness in his left ear, and hearing loss in the right ear. The patient’s retrospective exposure to pigs had been verified. It is important to evaluate predisposing and epidemiologic factors in order to alert about the possible presence of this etiological agent in cases of meningitis or bacteremia.
Streptococcus suis Meningitis: A Systematic Review and Meta-analysis  [PDF]
Anusha van Samkar?,Matthijs C. Brouwer?,Constance Schultsz?,Arie van der Ende?,Diederik van de Beek
PLOS Neglected Tropical Diseases , 2015, DOI: 10.1371/journal.pntd.0004191
Abstract: Background Streptococcus suis is the most common cause of meningitis in pork consuming and pig rearing countries in South-East Asia. We performed a systematic review of studies on S. suis meningitis to define the clinical characteristics, predisposing factors and outcome. Methodology Studies published between January 1, 1980 and August 1, 2015 were identified from main literature databases and reference lists. Studies were included if they were written in West-European languages and described at least 5 adult patients with S. suis meningitis in whom at least one clinical characteristic was described. Findings We identified 913 patients with S. suis meningitis included in 24 studies between 1980 and 2015. The mean age was 49 years and 581 of 711 patients were male (82%). Exposure to pigs or pork was present in 395 of 648 patients (61%) while other predisposing factors were less common. 514 of 528 patients presented with fever (97%), 429 of 451 with headache (95%), 462 of 496 with neck stiffness (93%) and 78 of 384 patients (20%) had a skin injury in the presence of pig/pork contact. The case fatality rate was 2.9% and hearing loss was a common sequel occurring in 259 of 489 patients (53%). Treatment included dexamethasone in 157 of 300 (52%) of patients and was associated with reduced hearing loss in S. suis meningitis patients included in a randomized controlled trial. Conclusion S. suis meningitis has a clear association with pig and pork contact. Mortality is low, but hearing loss occurs frequently. Dexamethasone was shown to reduce hearing loss.
Meningitis por Streptococcus suis en un paciente inmunocompetente
Nagel,A.; Manias,V.; Busquets,N.; Sniadowsky,S.; Anzardi,J.; Méndez,E. De Los A.;
Revista argentina de microbiolog?-a , 2008,
Abstract: a case of streptococcus suis meningitis is described in an immunocompetent patient presenting asthenia, general weakness, fever, vomiting, sensory deterioration and temporospatial disorder. the cerebrospinal fluid and two blood cultures (2/2 bottles) were positive. the isolate was preliminary identified by conventional biochemical tests, and the identification was completed at the special bacteriology service of inei-anlis "dr. carlos g. malbrán". ampicillin and ceftriaxone treatment was initiated. the isolate was susceptible to ampicillin, cefotaxime and vancomycin. the patient experienced a good outcome but suffered hearing loss. however, after four months he returned with walking ataxia, deafness in his left ear, and hearing loss in the right ear. the patient’s retrospective exposure to pigs had been verified. it is important to evaluate predisposing and epidemiologic factors in order to alert about the possible presence of this etiological agent in cases of meningitis or bacteremia.
Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes
Rossoni, Andrea Maciel de Oliveira;Dalla Costa, Libera Maria;Berto, Denize Bonato;Farah, S?nia Santos;Gelain, Marilene;Brandileone, Maria Cristina de Cunto;Ramos, Vitor Hugo Mariano;Almeida, Sergio Monteiro de;
Arquivos de Neuro-Psiquiatria , 2008, DOI: 10.1590/S0004-282X2008000400014
Abstract: the main objectives of this study are to evaluate the resistance rates of streptococcus pneumonia to penicillin g, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. the sensitiveness and serotypes of all isolated s. pneumoniae of patients with acute bacterial meningitis received by the paraná state central laboratory from april 2001 to august 2002 have been evaluated. one hundred s. pneumoniae have been isolated, of which 15% were resistant to penicillin, 1% to cephalosporin and 0% to vancomycin. the serotypes most found were 14 (19%), 3 and 23f (10% each). when only the resistant serotypes were analyzed, the most prevalent was the 14 with 44%. the risk factors found in relation to the s. pneumoniae resistance were: age under one year old (p=0.01) and previous use of antibiotic (p=0.046). the resistance rates found, which were moderate to penicillin, low to cephalosporin and neutral to vancomycin, suggest the isolated use of a 3rd generation cephalosporin as an initial empirical therapy for the treatment of acute bacterial meningitis with a communitarian background.
Pathophysiology of acute meningitis caused by Streptococcus pneumoniae and adjunctive therapy approaches
Barichello, Tatiana;Generoso, Jaqueline S.;Collodel, Allan;Moreira, Ana Paula;Almeida, Sérgio Monteiro de;
Arquivos de Neuro-Psiquiatria , 2012, DOI: 10.1590/S0004-282X2012000500011
Abstract: pneumococcal meningitis is a life-threatening disease characterized by an acute purulent infection affecting piamater, arachnoid and the subarachnoid space. the intense inflammatory host's response is potentially fatal and contributes to the neurological sequelae. streptococcus pneumoniae colonizes the nasopharynx, followed by bacteremia, microbial invasion and blood-brain barrier traversal. s. pneumoniae is recognized by antigen-presenting cells through the binding of toll-like receptors inducing the activation of factor nuclear kappa b or mitogen-activated protein kinase pathways and subsequent up-regulation of lymphocyte populations and expression of numerous proteins involved in inflammation and immune response. many brain cells can produce cytokines, chemokines and others pro-inflammatory molecules in response to bacteria stimuli, as consequence, polymorphonuclear are attracted, activated and released in large amounts of superoxide anion and nitric oxide, leading to the peroxynitrite formation, generating oxidative stress. this cascade leads to lipid peroxidation, mitochondrial damage, blood-brain barrier breakdown contributing to cell injury during pneumococcal meningitis.
The antimicrobial resistance patterns and associated determinants in Streptococcus suis isolated from humans in southern Vietnam, 1997-2008
Ngo T Hoa, Tran TB Chieu, Ho DT Nghia, Nguyen TH Mai, Pham H Anh, Marcel Wolbers, Stephen Baker, James I Campbell, Nguyen VV Chau, Tran T Hien, Jeremy Farrar, Constance Schultsz
BMC Infectious Diseases , 2011, DOI: 10.1186/1471-2334-11-6
Abstract: S. suis strains isolated between 1997 and 2008 were investigated for their susceptibility to six antimicrobial agents. Strains were screened for the presence and expression of tetracycline and erythromycin resistance determinants and the association of tet(M) genes with Tn916- like transposons. The localization of tetracycline resistance gene tet(L) was determined by pulse field gel electrophoresis and Southern blotting.We observed a significant increase in resistance to tetracycline and chloramphenicol, which was concurrent with an increase in multi-drug resistance. In tetracycline resistance strains, we identified tet(M), tet(O), tet(W) and tet(L) and confirmed their expression. All tet(M) genes were associated with a Tn916-like transposon. The co-expression of tet(L) and other tetracycline resistance gene(s) encoding for ribosomal protection protein(s) was only detected in strains with a minimum inhibitory concentration (MIC) of tetracycline of ≥ 64 mg/LWe demonstrated that multi-drug resistance in S. suis causing disease in humans in southern Vietnam has increased over the 11-year period studied. We report the presence and expression of tet(L) in S. suis strains and our data suggest that co-expression of multiple genes encoding distinct mechanism is required for an MIC ≥ 64 mg/L to tetracycline.Streptococcus suis is an emerging zoonotic pathogen associated with pigs and can cause severe systemic infections in humans. Up to date approximately 800 human S. suis infections have been reported from over twenty countries [1]. The most noticeable incident was a single outbreak in China affecting 215 individuals, of whom 38 died [2]. S. suis serotype 2 is the most common serotype associated with human disease [3] and is the most common cause of acute bacterial meningitis in adults in Vietnam [1,4,5].Antimicrobial susceptibility profiles and the corresponding resistance determinants of S. suis have been reported in strains isolated from pigs, but there are only limited d
Response of swine spleen to Streptococcus suis infection revealed by transcription analysis
Ran Li, Anding Zhang, Bo Chen, Liu Teng, Ya Wang, Huanchun Chen, Meilin Jin
BMC Genomics , 2010, DOI: 10.1186/1471-2164-11-556
Abstract: 104 and 129 unique genes were significantly up-regulated and down-regulated in the spleens of pigs infected with SS2 (WT). The up-regulated genes were principally related to immune response, such as genes involved in inflammatory response; acute-phase/immune response; cell adhesion and response to stress. The down-regulated genes were mainly involved in transcription, transport, material and energy metabolism which were representative of the reduced vital activity of SS2-influenced cells. Only a few genes showed significantly differential expression when comparing avirulent isogenic strain (ΔHP0197) with mock-infected samples.Our findings indicated that highly pathogenic SS2 could persistently induce cytokines mainly by Toll-like receptor 2 (TLR2) pathway, and the phagocytosis-resistant bacteria could induce high level of cytokines and secrete toxins to destroy deep tissues, and cause meningitis, septicaemia, pneumonia, endocarditis, and arthritis.Streptococcus suis (S. suis) is an important pathogen associated with many diseases in pigs, including meningitis, septicaemia, pneumonia, endocarditis, and arthritis. S. suis serotype 2 (SS2) is considered the most pathogenic as well as the most prevalent capsular type among thirty-three serotypes (types 1 to 31, 33, and 1/2) in diseased pigs, and it is also the causative agent of serious infections in humans, especially in people in close contact with pig or pork byproducts [1-3]. Two recent large-scale outbreaks of human SS2 epidemics in China (one had 25 cases with 14 deaths in Jiangsu in 1998, the second had 204 cases with 38 deaths in Sichuan in 2005), featured clinical streptococcal toxic shock syndrome, have greatly challenged the global public health [4-7]. Recently, S. suis infection has also caused sporadic human illness in other countries, including Thailand [8,9], United Kingdom [10], Portugal [11], Australia [12], Netherlands [13] and United States [14,15], and been recognized as the third most common cause o
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