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Lien CY, Chien CC, Lu CH, Chang WN. The clinical characteristics and therapeutic outcomes of adult patients with community-acquired spontaneous bacterial meningitis with a fulminant clinical course in Taiwan. BMC Infect Dis 2023; 23:859. [PMID: 38057727 DOI: 10.1186/s12879-023-08857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE To examine the clinical characteristics of adult patients with community-acquired spontaneous bacterial meningitis (CASBM) with a fulminant clinical course. MATERIALS AND METHODS The clinical features and therapeutic outcomes of 127 adult CASBM patients were analyzed. The patients were divided into two groups as those with and without a fulminant clinical course. Fulminant clinical course was defined as meningitis presenting initially with marked consciousness disturbance (Glasgow Coma Scale score < 8) or a rapid deterioration in consciousness level within 48 h of hospitalization. RESULTS Among the 127 enrolled patients, 69 had a fulminant clinical course (47 men and 22 women) and 58 did not. The patients with a fulminant clinical course had a significantly higher incidence of end-stage renal disease (ESRD), severe clinical manifestations and higher mortality rate, and the survivors had significantly worse therapeutic outcomes. Klebsiella (K.) pneumoniae (50 strains) was the most important pathogen for the development of a fulminant clinical course, and all strains were susceptible to ceftriaxone and ceftazidime. With treatment, 50.7% (35/69) of the patients with a fulminant clinical course died, and the presence of K. pneumoniae infection was significant prognostic factor. CONCLUSIONS The presence of ESRD, initial presentation of altered consciousness, septic shock, seizures and CSF total protein level and K. pneumoniae infection were significantly associated with a fulminant clinical course of adult CASBM, and patients with this specific infectious syndrome had high mortality and morbidity rates. The presence of K. pneumoniae infection is a significant prognostic factor.
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Affiliation(s)
- Chia-Yi Lien
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Section, Kaohsiung, Taiwan
| | - Chun-Chih Chien
- Department of laboratory medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Section, Kaohsiung, Taiwan
| | - Wen-Neng Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Section, Kaohsiung, Taiwan.
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Li Y, Hu D, Ma X, Li D, Tian D, Gong Y, Jiang X. Convergence of carbapenem-resistance and hypervirulence leads to high mortality in patients with postoperative Klebsiella pneumoniae meningitis. J Glob Antimicrob Resist 2021; 27:95-100. [PMID: 34133987 DOI: 10.1016/j.jgar.2021.02.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/13/2021] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the characteristics of Klebsiella pneumoniae meningitis and impact of convergence of carbapenem-resistance and hypervirulence on mortality. METHODS Drug-resistance and virulence-related genes were investigated in 25 K. pneumoniae strains causing meningitis. The clinical data of 25 patients (February 2009 to February 2019) were evaluated. Multilocus sequence typing, serotyping, mobile genetic element, and pulsed-field gel electrophoresis analysis were applied to generate the data. GraphPad Prism 8 was used for statistical analysis. RESULTS A mortality rate of 30.0% was found in the patients with K. pneumoniae meningitis. Significant differences were observed between the non-survivor and survivor groups in terms of mechanical ventilation, peripheral deep vein catheter insertion, ICU stay, and GCS and not in sex, age, and meningeal integrity destruction. Multi-drug resistance was found in 21 strains. Different detection rates were observed for each virulence gene, ranging from 8.0% in wzy-K1 to 100.0% in entB. Detection rates of carbapenem-resistant K. pneumoniae (CRKP), hypervirulent K. pneumoniae (HvKP), and hypervirulent carbapenem-resistant K. pneumoniae (Hv-CRKP) were 68.0%, 68.0%, and 48.0%, respectively. Totally 16 clusters and 19 clones were identified among the 25 strains. Mortality rates were significantly different between the non-Hv-CRKP (1/11) and Hv-CRKP groups (5/9), but comparable among the carbapenem-susceptible K. pneumoniae (CSKP)/CRKP groups and classical K. pneumoniae (cKP)/HvKP groups. CONCLUSIONS K. pneumoniae meningitis is associated with high mortality. K. pneumoniae-induced meningitis has highly divergent origins. Convergence of carbapenem-resistance and hypervirulence leads to high mortality in patients with K. pneumoniae meningitis, which is of great clinical concern.
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Affiliation(s)
- Yuming Li
- Department of Intensive Care Unit, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Dakang Hu
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Xiaobo Ma
- Department of Clinical Laboratory, the First Affiliated Hospital of Xiamen University (Xiamen Key Laboratory of Genetic Testing), Xiamen 361003, China.
| | - Dan Li
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Dongxing Tian
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Ye Gong
- Department of Intensive Care Unit, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Xiaofei Jiang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Elhaki T, Gheysarzadeh A, Sadeghifard N, Pakzad I, Behrouzi A, Taherikalani M, Jalilian FA, Tabasi M, Azizian R. Frequency of Iron Uptake Proteins Related Genes Among Klebsiella pneumoniae Isolates. Open Microbiol J 2020. [DOI: 10.2174/1874285802014010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aims:
The present study aimed to evaluate Iron uptake protein-related genes in clinical and environmental Klebsiella pneumoniae isolates.
Background:
Klebsiella pneumoniae as an opportunistic pathogen cause infections in immunocompromised patients. Iron uptake systems play an important role in the pathogenesis of Klebsiella pneumonia.
Objectives:
This study was designed to investigate the prevalence of iron uptake coding genes among isolates of Klebsiella pneumonia.
Materials and Methods:
A total of 300 isolates of Klebsiella pneumonia including 150 clinical isolates and 150 environmental isolates were selected. Finally, the frequency of iroN, iucD, kfuA,hmuR, and ybt [yHPI] genes were detected by PCR method.
Results:
The frequency of kfuA, iucD, iroN, yHPI in clinical isolates were 33.3%, 16.7%, 24.7%, 15.3%, respectively and these genes among environmental isolates were 20.7%, 6%, 49.3% and 0.7%, respectively. Among the clinical isolates, the most frequency genes were kfuA gene [50 isolates] and after that iroN [37 isolates], iucD [25 isolates] and yHPI [23 isolates], the genes with the most frequency among environmental isolates were iroN gene [74 isolates] and following that kfuA [31 isolates], iucD [9 isolates] and yHPI [1 isolate]. No hmuR positive samples among all clinical or environmental isolates were found.
Conclusion:
The result of this study showed that because of the high frequency of ferric iron system coding gene kfu among clinical isolates, this system might play an important role in the survival of bacteria against its host.
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Lien CY, Lee JJ, Tsai WC, Chen SY, Huang CR, Chien CC, Lu CH, Chang WN. The clinical characteristics of spontaneous Gram-negative bacterial meningitis in adults: A hospital-based study. J Clin Neurosci 2019; 64:101-105. [PMID: 31005474 DOI: 10.1016/j.jocn.2019.03.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/25/2019] [Indexed: 11/28/2022]
Abstract
The epidemiologic trend of acute bacterial meningitis can change more dramatically than any other bacterial disease, and a decrease in spontaneous adult bacterial meningitis (ABM) has been noted in serial studies of the epidemiologic trend of ABM in Taiwan. The purpose of this study was to analyze the clinical characteristics, laboratory data and therapeutic outcomes of 149 patients with spontaneous Gram-negative (G(-)) ABM collected during a study period of 31 years (1986-2016). The 149 patients included 107 men and 42 women, aged 18-86 years. The common underlying conditions were diabetes mellitus, liver cirrhosis and alcoholism, and the leading clinical presentations were fever, altered consciousness and septic shock. Compared the clinical characteristics of the patients identified in the study period of 2001-2106 to the patients identified in the study period of 1986-2000, the former group of patients had a significantly higher incidence of systemic malignance. In the recent 16 years (2001-2016), Klebsiella pneumoniae, Pseudomonas spp. and Escherichia coli were the leading three implicated bacterial pathogens of spontaneous G(-) ABM, accounting for 61.3% (38/62), 11.3% (7/62) and 11.3% (7/62%) of all cases, respectively. The overall mortality rate from spontaneous G(-) ABM was high (47.0%, 70/149) and the presence of septic shock and lower cerebrospinal fluid glucose level were significant prognostic factors. Because of the decreasing incidence of spontaneous ABM in Taiwan, close examination of this specific infectious syndrome is important in order to monitor the epidemiologic trend and improve the therapeutic strategy.
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Affiliation(s)
- Chia-Yi Lien
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jun-Jun Lee
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Information Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Wan-Chen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Ying Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chi-Ren Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Chih Chien
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Neng Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Pyra A, Brzozowska E, Pawlik K, Gamian A, Dauter M, Dauter Z. Tail tubular protein A: a dual-function tail protein of Klebsiella pneumoniae bacteriophage KP32. Sci Rep 2017; 7:2223. [PMID: 28533535 PMCID: PMC5440376 DOI: 10.1038/s41598-017-02451-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/11/2017] [Indexed: 11/09/2022] Open
Abstract
Tail tubular protein A (TTPA) is a structural tail protein of Klebsiella pneumoniae bacteriophage KP32, and is responsible for adhering the bacteriophage to host cells. For the first time, we found that TTPA also exhibits lytic activity towards capsular exopolysaccharide (EPS) of the multiresistant clinical strain of Klebsiella pneumoniae, PCM2713, and thus should be regarded as a dual-function macromolecule that exhibits both structural and enzymatic actions. Here, we present our crystallographic and enzymatic studies of TTPA. TTPA was crystallized and X-ray diffraction data were collected to a resolution of 1.9 Å. In the crystal, TTPA molecules were found to adopt a tetrameric structure with α-helical domains on one side and β-strands and loops on the other. The novel crystal structure of TTPA resembles those of the bacteriophage T7 tail protein gp11 and gp4 of bacteriophage P22, but TTPA contains an additional antiparallel β-sheet carrying a lectin-like domain that could be responsible for EPS binding. The enzymatic activity of TTPA may reflect the presence of a peptidoglycan hydrolase domain in the α-helical region (amino acid residues 126 to 173). These novel results provide new insights into the enzymatic mechanism through which TTPA acts on polysaccharides.
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Affiliation(s)
- Anna Pyra
- University of Wroclaw, Faculty of Chemistry, Department of Crystallography, 14 F. Joliot-Curie, Wroclaw, 50383, Poland.
| | - Ewa Brzozowska
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 R. Weigl, Wroclaw, 53114, Poland.
| | - Krzysztof Pawlik
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 R. Weigl, Wroclaw, 53114, Poland
| | - Andrzej Gamian
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 R. Weigl, Wroclaw, 53114, Poland
| | - Miroslawa Dauter
- Leidos Biomedical Research Inc., Basic Research Program, Argonne National Laboratory, Argonne, IL, 60439, USA
| | - Zbigniew Dauter
- Synchrotron Radiation Research Section, MCL, National Cancer Institute, Argonne National Laboratory, Argonne, IL, 60439, USA
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Alcántar-Curiel MD, Girón JA. Klebsiella pneumoniae and the pyogenic liver abscess: implications and association of the presence of rpmA genes and expression of hypermucoviscosity. Virulence 2015; 6:407-9. [PMID: 25951089 PMCID: PMC4601161 DOI: 10.1080/21505594.2015.1030101] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Roe WD, Rogers L, Pinpimai K, Dittmer K, Marshall J, Chilvers BL. Septicaemia and meningitis caused by infection of New Zealand sea lion pups with a hypermucoviscous strain of Klebsiella pneumoniae. Vet Microbiol 2015; 176:301-8. [PMID: 25682024 DOI: 10.1016/j.vetmic.2015.01.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/19/2015] [Accepted: 01/20/2015] [Indexed: 10/24/2022]
Abstract
This study describes a syndrome of neonatal septicemia and meningitis in New Zealand sea lions, caused by a strain of Klebsiella pneumoniae that is phenotypically similar to strains causing environmentally-acquired septicemia and neuro-invasive disease in humans. Between late 2006 and early 2010, 123 pups from the Enderby Island breeding colony died of K. pneumoniae infection, with lesions including fibrinous to fibrinosuppurative meningitis, subdural hemorrhage, septic arthritis, herniation and hemorrhage of the cerebellar vermis, lymphadenitis and cellulitis. This infection was responsible for 58% of observed pup mortality over this time period, with most deaths occurring in the latter part of the breeding season (mid February onwards). The results of this study suggest that the pattern of this disease has changed since it was first described in 2002, when most deaths occurred early in the season (early to mid-January), and that it is an important and consistent cause of pup mortality in this population. In addition, a similar disease syndrome and bacterial strain was diagnosed in a single pup in a fragile recolonizing New Zealand sea lion population on mainland New Zealand, and the potential effect on this population is unknown but could have a negative impact on recolonisation at this site.
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Affiliation(s)
- W D Roe
- Pathobiology Group, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand.
| | - L Rogers
- mEpiLab, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - K Pinpimai
- Pathobiology Group, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - K Dittmer
- Pathobiology Group, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - J Marshall
- mEpiLab, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - B L Chilvers
- Department of Conservation, Wellington, New Zealand
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Teckie G, Karstaedt A. Spontaneous adult Gram-negative bacillary meningitis in Soweto, South Africa. Int J Infect Dis 2014; 30:38-40. [PMID: 25447721 DOI: 10.1016/j.ijid.2014.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 10/23/2014] [Accepted: 10/25/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Gram-negative bacillary (GNB) meningitis is a rare cause of meningitis in adults and can occur as a spontaneous infection or as a complication of a neurosurgical procedure or trauma. We aimed to describe the characteristics and outcomes of adults with spontaneous GNB meningitis. METHODS A retrospective cohort analysis was performed of 26 patients with GNB meningitis seen at a single hospital in Soweto, South Africa. RESULTS A predisposing condition was found in 24 (92%) patients. The 19 (73%) HIV-infected patients had a median CD4 count of 24/mm(3). Chronic renal disease, diabetes mellitus, myeloma, and alcoholism were other underlying conditions. The HIV-infected had a median cerebrospinal fluid (CSF) neutrophil count of 2/mm(3) compared to the HIV-non-infected of 560/mm(3). Common organisms were Escherichia coli, Klebsiella pneumoniae, and non-typhoidal Salmonella in HIV-positive patients and K. pneumoniae in the HIV-negative group. Ten (38%) isolates were resistant to third-generation cephalosporins. Mortality was 65%. CONCLUSIONS A disproportionate burden of GNB meningitis fell on the HIV-infected, among whom absent or low CSF white cells was common. Management was complicated by high rates of resistance to third-generation cephalosporins.
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Affiliation(s)
- Gloria Teckie
- Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Hospital and Faculty of Health Sciences, University of the Witwatersrand, PO Bertsham, 2013 Johannesburg, South Africa
| | - Alan Karstaedt
- Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Hospital and Faculty of Health Sciences, University of the Witwatersrand, PO Bertsham, 2013 Johannesburg, South Africa.
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Zhou H, Zhang X. Intracranial malignant lesions correlate with the requirement for a long treatment course in postoperative central nervous system infection. Neuropsychiatr Dis Treat 2014; 10:2071-7. [PMID: 25395855 PMCID: PMC4226452 DOI: 10.2147/ndt.s71836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
AIM Our aim was to study the clinical features of postoperative meningitis after neurosurgery and identify the factors affecting the duration of treatment. METHODS This retrospective study assessed 283 patients with postoperative bacterial meningitis in the Neurosurgery Department of Beijing Tiantan Hospital, Beijing, People's Republic of China, between January and December 2012. Patients' clinical data were reviewed, and multivariate logistic regression analysis was used to identify the factors associated with a prolonged treatment course. RESULTS The mortality rate was 0.4% in these patients, of whom 12.4% were found with pathogens in the cerebrospinal fluid. Among the three most common pathogens detected were methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, and Pseudomonas aeruginosa. The mean treatment course was 13.5±2.1 days. Interestingly, the treatment duration for postoperative meningitis was significantly longer in patients with intracranial malignant tumors than in those with benign lesions. Single-factor analysis showed that male sex (P=0.042) and malignant (rather than benign) lesions (P<0.001) were significantly associated with prolonged treatment duration. Multivariate analysis further confirmed that malignant intracranial lesions represented an independent risk factor for prolonged treatment duration (odds ratio: 2.5962; 95% confidence interval: 1.1092-6.6134). CONCLUSION The nature of the intracranial lesion is an independent risk factor for the duration of treatment in postoperative meningitis after neurosurgery.
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Affiliation(s)
- Heng Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xinghu Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
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Barichello T, Simões LR, Generoso JS, Carradore MM, Moreira AP, Panatto AP, Costa CS, Filho AS, Jeremias IC, Bez GD, Streck E. Evaluation of energetic metabolism in the rat brain after meningitis induction by Klebsiella pneumoniae. Acta Neuropsychiatr 2013; 25:95-100. [PMID: 25287310 DOI: 10.1111/j.1601-5215.2012.00671.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bacterial meningitis is an infection of the central nervous system characterised by strong inflammatory response. The brain is highly dependent on ATP, and the cell energy is obtained through oxidative phosphorylation, a process which requires the action of various respiratory enzyme complexes and creatine kinase (CK) as an effective buffering system of cellular ATP levels in tissues that consume high energy. OBJECTIVES Evaluate the activities of mitochondrial respiratory chain complexes I, II, III, IV and CK activity in hippocampus and cortex of the Wistar rat submitted to meningitis by Klebsiella pneumoniae. METHODS Adult Wistar rats received either 10 µl of sterile saline as a placebo or an equivalent volume of K. pneumoniae suspension. The animals were killed in different times at 6, 12, 24 and 48 h after meningitis induction. Another group was treated with antibiotic, starting at 16 h and continuing daily until their decapitation at 24 and 48 h after induction. RESULTS In the hippocampus, the meningitis group without antibiotic treatment, the complex I was increased at 24 and 48 h, complex II was increased at 48 h, complex III was inhibited at 6, 12, 24 and 48 h and in complex IV all groups with or without antibiotic treatment were inhibited after meningitis induction, in the cortex there was no alteration. Discussion Although descriptive, our results show that antibiotic prevented in part the changes of the mitochondrial respiratory chain. The meningitis model could be a good research tool to study the biological mechanisms involved in the pathophysiology of the K. pneumoniae meningitis.
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Affiliation(s)
- Tatiana Barichello
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Lutiana Roque Simões
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Jaqueline S Generoso
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Mirelle M Carradore
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Ana Paula Moreira
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Ana Paula Panatto
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Caroline S Costa
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Alvaro Steckert Filho
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Isabela C Jeremias
- 2 Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Gisele D Bez
- 2 Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Emilio Streck
- 2 Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
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Yaita K, Komatsu M, Oshiro Y, Yamaguchi Y. Postoperative meningitis and epidural abscess due to extended-spectrum β-lactamase-producing Klebsiella pneumoniae: a case report and a review of the literature. Intern Med 2012; 51:2645-8. [PMID: 22989843 DOI: 10.2169/internalmedicine.51.8068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
17-year-old man had been involved in a traffic accident. He underwent a bilateral craniotomy with artificial dura mater to remove bilateral acute subdural hematomas. Seven months later, a right cranioplasty was performed using frozen auto-bone, and he developed extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae meningitis and an epidural abscess. Since his general status was poor, we could not remove the foreign body (artificial dura mater). He was successfully treated with meropenem and chronic suppression with oral trimethoprim-sulfamethoxazole. By describing this case and the results of a review of the pertinent literature, we discuss the importance of ESBL-producing Klebsiella pneumoniae meningitis in posttraumatic/postoperative patients.
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Affiliation(s)
- Kenichiro Yaita
- Division of Infectious Diseases, Kenwakai Otemachi Hospital, Japan.
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12
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Huang CR, Lu CH, Chuang YC, Chen SF, Tsai NW, Chang CC, Lui CC, Wang HC, Chien CC, Chang WN. Clinical characteristics and therapeutic outcome of Gram-negative bacterial spinal epidural abscess in adults. J Clin Neurosci 2011; 18:213-7. [DOI: 10.1016/j.jocn.2010.05.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 05/11/2010] [Accepted: 05/15/2010] [Indexed: 10/18/2022]
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