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  1 / 2178 MEDLINE  
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[PMID]:29269697
[Au] Autor:Himeno T; Shiga Y; Takeshima S; Tachiyama K; Kamimura T; Kono R; Takemaru M; Takeshita J; Shimoe Y; Kuriyama M
[Ad] Endereço:Department of Neurology, Brain Attack Center, Ota Memorial Hospital.
[Ti] Título:[Clinical, epidemiological, and etiological studies of adult aseptic meningitis: a report of 12 cases of herpes simplex meningitis, and a comparison with cases of herpes simplex encephalitis].
[So] Source:Rinsho Shinkeigaku;58(1):1-8, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:We treated 437 cases of adult aseptic meningitis and 12 cases (including 2 recurrent patients; age, 31.8 ± 8.9 years; 7 females) of herpes simplex meningitis from 2004 to 2016. The incidence rate of adult herpes simplex meningitis in the cases with aseptic meningitis was 2.7%. One patient was admitted during treatment of genital herpes, but no association was observed between genital herpes and herpes simplex meningitis in the other cases. The diagnoses were confirmed in all cases as the cerebrospinal fluid (CSF) was positive for herpes simplex virus (HSV)-DNA. For diagnosis confirmation, the DNA test was useful after 2-7 days following initial disease onset. Among other types of aseptic meningitis, the patients with herpes simplex meningitis showed relatively high white blood cell counts and relatively high CSF protein and high CSF cell counts. CSF cells showed mononuclear cell dominance from the initial stage of the disease. During same period, we also experienced 12 cases of herpes simplex encephalitis and 21 cases of non-hepatic acute limbic encephalitis. Notably, the patients with herpes simplex meningitis were younger and their CSF protein and cells counts were higher than those of the patients with herpes simplex encephalitis.
[Mh] Termos MeSH primário: Encefalite por Herpes Simples
Herpes Simples
Meningite Viral
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Biomarcadores/líquido cefalorraquidiano
Contagem de Células
Líquido Cefalorraquidiano/citologia
Proteínas do Líquido Cefalorraquidiano/líquido cefalorraquidiano
DNA Viral/líquido cefalorraquidiano
Encefalite por Herpes Simples/líquido cefalorraquidiano
Encefalite por Herpes Simples/diagnóstico
Encefalite por Herpes Simples/epidemiologia
Encefalite por Herpes Simples/virologia
Feminino
Seres Humanos
Masculino
Meningite Viral/líquido cefalorraquidiano
Meningite Viral/diagnóstico
Meningite Viral/epidemiologia
Meningite Viral/virologia
Meia-Idade
Simplexvirus/genética
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Cerebrospinal Fluid Proteins); 0 (DNA, Viral)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001098


  2 / 2178 MEDLINE  
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[PMID]:28858084
[Au] Autor:Sanaei Dashti A; Alizadeh S; Karimi A; Khalifeh M; Shoja SA
[Ad] Endereço:aProfessor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz bPediatric Infectious Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
[Ti] Título:Diagnostic value of lactate, procalcitonin, ferritin, serum-C-reactive protein, and other biomarkers in bacterial and viral meningitis: A cross-sectional study.
[So] Source:Medicine (Baltimore);96(35):e7637, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There are many difficulties distinguishing bacterial from viral meningitis that could be reasonably solved using biomarkers. The aim of this study was to evaluate lactate, procalcitonin (PCT), ferritin, serum-CRP (C-reactive protein), and other known biomarkers in differentiating bacterial meningitis from viral meningitis in children.All children aged 28 days to 14 years with suspected meningitis who were admitted to Mofid Children's Hospital, Tehran, between October 2012 and November 2013, were enrolled in this prospective cross-sectional study. Children were divided into 2 groups of bacterial and viral meningitis, based on the results of cerebrospinal fluid (CSF) culture, polymerase chain reaction, and cytochemical profile. Diagnostic values of CSF parameters (ferritin, PCT, absolute neutrophil count [ANC], white blood cell count, and lactate) and serum parameters (PCT, ferritin, CRP, and erythrocyte sedimentation rate [ESR]) were evaluated.Among 50 patients with meningitis, 12 were diagnosed with bacterial meningitis. Concentrations of all markers were significantly different between bacterial and viral meningitis, except for serum (P = .389) and CSF (P = .136) PCT. The best rates of area under the receiver operating characteristic (ROC) curve (AUC) were achieved by lactate (AUC = 0.923) and serum-CRP (AUC = 0.889). The best negative predictive values (NPV) for bacterial meningitis were attained by ANC (100%) and lactate (97.1%).The results of our study suggest that ferritin and PCT are not strong predictive biomarkers. A combination of low CSF lactate, ANC, ESR, and serum-CRP could reasonably rule out the bacterial meningitis.
[Mh] Termos MeSH primário: Biomarcadores/sangue
Meningites Bacterianas/diagnóstico
Meningite Viral/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Proteína C-Reativa/metabolismo
Calcitonina/sangue
Criança
Serviços de Saúde da Criança
Pré-Escolar
Estudos Transversais
Feminino
Ferritinas/sangue
Ferritinas/líquido cefalorraquidiano
Seres Humanos
Lactente
Irã (Geográfico)
Ácido Láctico/sangue
Masculino
Meningites Bacterianas/sangue
Meningites Bacterianas/líquido cefalorraquidiano
Meningite Viral/sangue
Meningite Viral/líquido cefalorraquidiano
Valor Preditivo dos Testes
Estudos Prospectivos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 33X04XA5AT (Lactic Acid); 9007-12-9 (Calcitonin); 9007-41-4 (C-Reactive Protein); 9007-73-2 (Ferritins)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007637


  3 / 2178 MEDLINE  
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[PMID]:28837564
[Au] Autor:Christie D; Rashid H; El-Bashir H; Sweeney F; Shore T; Booy R; Viner RM
[Ad] Endereço:UCL Institute of Epidemiology & Health Care, London, United Kingdom.
[Ti] Título:Impact of meningitis on intelligence and development: A systematic review and meta-analysis.
[So] Source:PLoS One;12(8):e0175024, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We undertook a systematic review and meta-analysis to address the question "what is the impact of meningitis on IQ and development." METHODS: Search: conducted using standardized search terms across Medline, PsychInfo and EMBASE to 06/2014. Eligibility: human studies of any infectious aetiology of meningitis reporting IQ or infant developmental age or stage outcomes. Quality: Centre for Evidence Based Medicine, Oxford, quality tools. Analysis: random effects meta-analysis by organism. RESULTS: 39 studies were included in the review, 34 providing data on IQ (2015 subjects) and 12 on developmental delay (382 subjects). Across all bacterial organisms, meningitis survivors had a mean IQ 5.50 (95% CI: -7.19, -3.80; I2 = 47%, p = 0.02) points lower than controls. IQ was significantly lower than controls for Neisseria meningitides (NM: 5 points) and Haemophilus influenzae b (Hib: 6 points) but not in viral meningitis, with only single studies included for Streptococcus pneumoniae (SP) and group B streptococcus (GBS). The pooled relative risk (RR) for low IQ (IQ<70) in survivors of bacterial meningitis compared with controls was 4.99 (95% CI: 3.17, 7.86) with no significant heterogeneity (I2 = 49%, p = 0.07). Developmental delay of approximately 0.5SD was reported in studies of bacterial meningitis but no delay in the only study of viral meningitis. CONCLUSIONS: We found moderate evidence that surviving bacterial meningitis has a deleterious impact on IQ and development but no evidence that viral meningitis had meaningful cognitive impacts. Survivors of bacterial meningitis should be routinely offered screening for cognitive deficits and developmental delay in addition to hearing loss.
[Mh] Termos MeSH primário: Inteligência
Meningites Bacterianas/psicologia
Meningite Viral/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
Meningites Bacterianas/patologia
Meningite Viral/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170825
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175024


  4 / 2178 MEDLINE  
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[PMID]:28804114
[Au] Autor:Takeshima S; Shiga Y; Himeno T; Tachiyama K; Kamimura T; Kono R; Takemaru M; Takeshita J; Shimoe Y; Kuriyama M
[Ad] Endereço:Department of Neurology, Brain Attack Center, Ota Memorial Hospital.
[Ti] Título:Clinical, epidemiological and etiological studies of adult aseptic meningitis: Report of 11 cases with varicella zoster virus meningitis.
[So] Source:Rinsho Shinkeigaku;57(9):492-498, 2017 09 30.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:We treated 11 cases (52.7 ± 14.9 years, all male) with varicella zoster virus (VZV) meningitis and 437 cases with adult aseptic meningitis from 2004 to 2016. The incidence rate of adult VZV meningitis in the cases with aseptic meningitis was 2.5%. Herpes zoster infections are reported to have occurred frequently in summer and autumn. VZV meningitis also occurred frequently in the similar seasons, in our patients. The diagnoses were confirmed in 9 cases with positive VZV-DNA in the cerebrospinal fluid and in 2 cases with high VZV-IgG indexes (> 2.0). For diagnosis confirmation, the former test was useful for cases within a week of disease onset, and the latter index was useful for cases after a week of disease onset. Zoster preceded the meningitis in 8 cases, while the meningitis preceded zoster in 1 case, and 2 cases did not have zoster (zoster sine herpete). Two patients were carriers of the hepatitis B virus, 1 patient was administered an influenza vaccine 4 days before the onset of meningitis, and 1 patient was orally administered prednisolone for 2 years, for treatment. Their immunological activities might have been suppressed. The neurological complications included trigeminal neuralgia, facial palsy (Ramsay Hunt syndrome), glossopharyngeal neuralgia, and Elsberg syndrome. Because the diseases in some patients can become severe, they require careful treatment.
[Mh] Termos MeSH primário: Herpes Zoster
Herpesvirus Humano 3
Meningite Viral
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biomarcadores/sangue
Fenda Labial/etiologia
Fissura Palatina/etiologia
DNA Viral/sangue
Ectrópio/etiologia
Paralisia Facial/etiologia
Doenças do Nervo Glossofaríngeo/etiologia
Herpes Zoster/complicações
Herpes Zoster/diagnóstico
Herpes Zoster/epidemiologia
Herpes Zoster/virologia
Herpesvirus Humano 3/genética
Herpesvirus Humano 3/imunologia
Seres Humanos
Imunoglobulina G/sangue
Japão/epidemiologia
Masculino
Meningite Viral/complicações
Meningite Viral/diagnóstico
Meningite Viral/epidemiologia
Meningite Viral/virologia
Meia-Idade
Estações do Ano
Índice de Gravidade de Doença
Anormalidades Dentárias/etiologia
Neuralgia do Trigêmeo/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (DNA, Viral); 0 (Immunoglobulin G)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001054


  5 / 2178 MEDLINE  
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[PMID]:28796045
[Au] Autor:Gowin E; Januszkiewicz-Lewandowska D; Slowinski R; Blaszczynski J; Michalak M; Wysocki J
[Ad] Endereço:aDepartment of Family Medicine bDepartment of Oncology, Hematology and Bone Marrow Transplantation cDepartment of Molecular Pathology, Institute of Human Genetics Polish Academy of Sciences dDepartment of Medical Diagnostics eInstitute of Computing Science, Poznan University of Technology fDepartment of Biostatistics gDepartment of Health Promotion, Poznan University of Medical Sciences, Poznan, Poland.
[Ti] Título:With a little help from a computer: discriminating between bacterial and viral meningitis based on dominance-based rough set approach analysis.
[So] Source:Medicine (Baltimore);96(32):e7635, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Differential Diagnosis of bacterial and viral meningitis remains an important clinical problem. A number of methods to assist in the diagnoses of meningitis have been developed, but none of them have been found to have high specificity with 100% sensitivity.We conducted a retrospective analysis of the medical records of 148 children hospitalized in St. Joseph Children's Hospital in Poznan. In this study, we applied for the first time the original methodology of dominance-based rough set approach (DRSA) to diagnostic patterns of meningitis data and represented them by decision rules useful in discriminating between bacterial and viral meningitis. The induction algorithm is called VC-DomLEM; it has been implemented as software package called jMAF (http://www.cs.put.poznan.pl/jblaszczynski/Site/jRS.html), based on java Rough Set (jRS) library.In the studied group, there were 148 patients (78 boys and 70 girls), and the mean age was 85 months. We analyzed 14 attributes, of which only 4 were used to generate the 6 rules, with C-reactive protein (CRP) being the most valuable.Factors associated with bacterial meningitis were: CRP level ≥86 mg/L, number of leukocytes in cerebrospinal fluid (CSF) ≥4481 µL, symptoms duration no longer than 2 days, or age less than 1 month. Factors associated with viral meningitis were CRP level not higher than 19 mg/L, or CRP level not higher than 84 mg/L in a patient older than 11 months with no more than 1100 µL leukocytes in CSF.We established the minimum set of attributes significant for classification of patients with meningitis. This is new set of rules, which, although intuitively anticipated by some clinicians, has not been formally demonstrated until now.
[Mh] Termos MeSH primário: Diagnóstico por Computador/métodos
Meningites Bacterianas/diagnóstico
Meningite Viral/sangue
Meningite Viral/diagnóstico
[Mh] Termos MeSH secundário: Algoritmos
Proteína C-Reativa/análise
Criança
Pré-Escolar
Diagnóstico Diferencial
Feminino
Seres Humanos
Lactente
Contagem de Leucócitos
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170827
[Lr] Data última revisão:
170827
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007635


  6 / 2178 MEDLINE  
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[PMID]:28705656
[Au] Autor:Aronson PL; Lyons TW; Cruz AT; Freedman SB; Okada PJ; Fleming AH; Arms JL; Thompson AD; Schmidt SM; Louie J; Alfonzo MJ; Monuteaux MC; Nigrovic LE; Pediatric Emergency Medicine Clinical Research Network (PEM CRC) Herpes Simplex Virus (HSV) Study Group
[Ad] Endereço:Departments of Pediatrics and of Emergency Medicine, Yale School of Medicine, New Haven, CT.
[Ti] Título:Impact of Enteroviral Polymerase Chain Reaction Testing on Length of Stay for Infants 60 Days Old or Younger.
[So] Source:J Pediatr;189:169-174.e2, 2017 Oct.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the impact of a cerebrospinal fluid enterovirus polymerase chain reaction (PCR) test performance on hospital length of stay (LOS) in a large multicenter cohort of infants undergoing evaluation for central nervous system infection. STUDY DESIGN: We performed a planned secondary analysis of a retrospective cohort of hospitalized infants ≤60 days of age who had a cerebrospinal fluid culture obtained at 1 of 18 participating centers (2005-2013). After adjustment for patient age and study year as well as clustering by hospital center, we compared LOS for infants who had an enterovirus PCR test performed vs not performed and among those tested, for infants with a positive vs negative test result. RESULTS: Of 19 953 hospitalized infants, 4444 (22.3%) had an enterovirus PCR test performed and 945 (21.3% of tested infants) had positive test results. Hospital LOS was similar for infants who had an enterovirus PCR test performed compared with infants who did not (incident rate ratio 0.98 hours; 95% CI 0.89-1.06). However, infants PCR positive for enterovirus had a 38% shorter LOS than infants PCR negative for enterovirus (incident rate ratio 0.62 hours; 95% CI 0.57-0.68). No infant with a positive enterovirus PCR test had bacterial meningitis (0%; 95% CI 0-0.4). CONCLUSIONS: Although enterovirus PCR testing was not associated with a reduction in LOS, infants with a positive enterovirus PCR test had a one-third shorter LOS compared with infants with a negative enterovirus PCR test. Focused enterovirus PCR test use could increase the impact on LOS for infants undergoing cerebrospinal fluid evaluation.
[Mh] Termos MeSH primário: Líquido Cefalorraquidiano/virologia
Infecções por Enterovirus/diagnóstico
Enterovirus/genética
Tempo de Internação/estatística & dados numéricos
Meningite Viral/diagnóstico
Reação em Cadeia da Polimerase/métodos
[Mh] Termos MeSH secundário: Estudos de Coortes
Feminino
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE


  7 / 2178 MEDLINE  
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[PMID]:28705180
[Au] Autor:Ai J; Xie Z; Liu G; Chen Z; Yang Y; Li Y; Chen J; Zheng G; Shen K
[Ad] Endereço:Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Virology Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing,
[Ti] Título:Etiology and prognosis of acute viral encephalitis and meningitis in Chinese children: a multicentre prospective study.
[So] Source:BMC Infect Dis;17(1):494, 2017 Jul 14.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In China, there were few studies about the pathogens of acute viral encephalitis and meningitis in children in recent years. The aims of this study were to characterize the etiology and prognosis of acute viral encephalitis and meningitis in Chinese children. METHODS: This was a multicentre prospective study. Two hundred and sixty one viral encephalitis patients and 285 viral meningitis patients were enrolled. The mean age of viral encephalitis and meningitis were 5.88 ± 3.60 years and 6.39 ± 3.57 years, respectively. Real-time reverse transcription PCR and multiplex PCR were used to detect human enteroviruses and herpes viruses in cerebrospinal fluid (CSF) of patients with encephalitis or meningitis. The enzyme-linked immune absorbent assay (ELISA) was used for detecting IgM antibody against Japanese encephalitis virus (JEV) in CSF and against mumps virus, tick-borne encephalitis virus (TBEV), dengue virus and rubella virus in acute serum. The clinical and outcome data were collected during patients' hospitalization. RESULTS: The etiology of viral encephalitis was confirmed in 52.5% patients. The primary pathogen was human enteroviruses (27.7%) in viral encephalitis. The incidence of sequelae and the fatality rate of viral encephalitis with confirmed etiology were 7.5% and 0.8%, respectively. The etiology of viral meningitis was identified in 42.8% cases. The leading pathogen was also human enteroviruses (37.7%) in viral meningitis. The prognosis of viral meningitis was favorable with only 0.7% patients had neurological sequelae. CONCLUSIONS: Human enteroviruses were the leading cause both in acute viral encephalitis and viral meningitis in children. The incidence of sequelae and fatality rate of viral encephalitis with confirmed etiology were 7.5% and 0.8%, respectively. The prognosis of viral meningitis was favorable compared to viral encephalitis.
[Mh] Termos MeSH primário: Encefalite Viral/etiologia
Meningite Viral/etiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
China/epidemiologia
Vírus da Encefalite Japonesa (Espécie)/imunologia
Vírus da Encefalite Japonesa (Espécie)/patogenicidade
Vírus da Encefalite Transmitidos por Carrapatos/imunologia
Vírus da Encefalite Transmitidos por Carrapatos/patogenicidade
Encefalite Viral/epidemiologia
Enterovirus/genética
Enterovirus/imunologia
Enterovirus/patogenicidade
Feminino
Seres Humanos
Incidência
Lactente
Masculino
Meningite Viral/epidemiologia
Reação em Cadeia da Polimerase Multiplex
Prognóstico
Estudos Prospectivos
Vírus da Rubéola/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2572-9


  8 / 2178 MEDLINE  
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[PMID]:28397477
[Au] Autor:Akkaya O; Guvenc HI; Yuksekkaya S; Opus A; Guzelant A; Kaya M; Kurtoglu MG; Kaya N
[Ti] Título:Real-time PCR Detection of the Most Common Bacteria and Viruses Causing Meningitis.
[So] Source:Clin Lab;63(4):827-832, 2017 Apr 01.
[Is] ISSN:1433-6510
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Central nervous system (CNS) infections require prompt diagnosis, as the clinical condition progresses rapidly and may lead to severe permanent sequelae or death. The causative agents include viruses, bacteria, fungi, and parasites. In this study, samples with the diagnosis of CNS infection based on cerebrospinal fluid (CSF) sent to us from other hospitals/labs, were studied by multiplex real-time Polymerase Chain Reaction (PCR) method. The purpose of this study is to demonstrate, retrospectively, the most common bacteria and viruses causing meningitis and seasonal distribution of these agents using the multiplex real-time PCR method in CSF samples. METHODS: This study retrospectively evaluated the results of 470 CSF specimens that had been sent to the Molecular Unit of our hospital with a pre-diagnosis of CNS infection and had been tested with the PCR method between January 2014 and December 2015. Specimens were tested using multiplex real-time PCR assay for Adenovirus (AdV), Cytomegalovirus (CMV), Enteroviruses (EV) (Polioviruses, Coxackieviruses, Echoviruses, and other enteroviruses), Epstein- Barr virus (EBV), Herpes simplex virus 1 and 2, Human Herpes virus 6 and 7, Varicella-zoster virus (VZV), Human Parechoviruses and Parvovirus B19, Hemophilus influenzae, Streptococcus pneumoniae or Neisseria meningitidis. (FTD NEURO9 and FTD Bacterial meningitis, multiplex real-time PCR Kit). RESULTS: A bacterial or viral agent was identified in 98 (21%) of the 470 CSF samples. Of the patients, 85% were children and 15% were adults. Of the 98 positive samples, 22 (22.5%) patients were 15 years or older, and the remaining 76 (77.5%) were younger than 15 years. While Enterovirus (25%) was the most frequently identified agent, Adenovirus ranked second (22%) and Streptococcus pneumoniae ranked third (15%) in total. Positivity was highest in the 0 - 5-year age range. Bacteria were detected with the PCR method in 22 patients: S. pneumonia in 14, and N. meningitidis in 8. In cultures, S. pneumonia grew only in 7 and N. meningitidis in one. EV and AdV were seen in the summer months. The two coexisted in 3 (3%) patients. CONCLUSIONS: Early diagnosis and treatment of meningitis are very important for reducing its mortality and morbidity. In patients with suspected meningitis, early detection of the responsible agents may be possible with molecular methods, such as PCR. Significant economic benefits may be obtained by preventing unnecessary antibiotic use and hospitalizations through the early detection of the microbial agents.
[Mh] Termos MeSH primário: Meningite Viral
Reação em Cadeia da Polimerase em Tempo Real
[Mh] Termos MeSH secundário: Seres Humanos
Reação em Cadeia da Polimerase
Estudos Retrospectivos
Viroses
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE
[do] DOI:10.7754/Clin.Lab.2016.160912


  9 / 2178 MEDLINE  
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[PMID]:28346504
[Au] Autor:Khumalo J; Nicol M; Hardie D; Muloiwa R; Mteshana P; Bamford C
[Ad] Endereço:Division of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
[Ti] Título:Diagnostic accuracy of two multiplex real-time polymerase chain reaction assays for the diagnosis of meningitis in children in a resource-limited setting.
[So] Source:PLoS One;12(3):e0173948, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Accurate etiological diagnosis of meningitis is important, but difficult in resource-limited settings due to prior administration of antibiotics and lack of viral diagnostics. We aimed to develop and validate 2 real-time multiplex PCR (RT-PCR) assays for the detection of common causes of community-acquired bacterial and viral meningitis in South African children. METHODS: We developed 2 multiplex RT- PCRs for detection of S. pneumoniae, N. meningitidis, H. influenzae, enteroviruses, mumps virus and herpes simplex virus. We tested residual CSF samples from children presenting to a local paediatric hospital over a one-year period, whose CSF showed an abnormal cell count. Results were compared with routine diagnostic tests and the final discharge diagnosis. We calculated accuracy of the bacterial RT-PCR assay compared to CSF culture and using World Health Organisation definitions of laboratory-confirmed bacterial meningitis. RESULTS: From 292 samples, bacterial DNA was detected in 12 (4.1%) and viral nucleic acids in 94 (32%). Compared to CSF culture, the sensitivity and specificity of the bacterial RT-PCR was 100% and 97.2% with complete agreement in organism identification. None of the cases positive by viral RT-PCR had a bacterial cause confirmed on CSF culture. Only 9/90 (10%) of patients diagnosed clinically as bacterial meningitis or partially treated bacterial meningitis tested positive with the bacterial RT-PCR. DISCUSSION: In this population the use of 2 multiplex RT-PCRs targeting 6 common pathogens gave promising results. If introduced into routine diagnostic testing, these multiplex RT-PCR assays would supplement other diagnostic tests, and have the potential to limit unnecessary antibiotic therapy and hospitalisation.
[Mh] Termos MeSH primário: Bactérias/isolamento & purificação
Meningites Bacterianas/diagnóstico
Meningites Bacterianas/microbiologia
Meningite Viral/diagnóstico
Meningite Viral/virologia
Reação em Cadeia da Polimerase Multiplex/métodos
Vírus/isolamento & purificação
[Mh] Termos MeSH secundário: Bactérias/genética
Criança
Pré-Escolar
DNA Bacteriano/genética
DNA Bacteriano/isolamento & purificação
Enterovirus/genética
Enterovirus/isolamento & purificação
Feminino
Haemophilus influenzae/genética
Haemophilus influenzae/isolamento & purificação
Seres Humanos
Masculino
Meningites Bacterianas/líquido cefalorraquidiano
Meningites Bacterianas/epidemiologia
Meningite Viral/líquido cefalorraquidiano
Meningite Viral/epidemiologia
Vírus da Caxumba/genética
Vírus da Caxumba/isolamento & purificação
Neisseria meningitidis/genética
Neisseria meningitidis/isolamento & purificação
Ácidos Nucleicos/genética
Ácidos Nucleicos/isolamento & purificação
Sensibilidade e Especificidade
Simplexvirus/genética
Simplexvirus/isolamento & purificação
África do Sul
Streptococcus pneumoniae/genética
Streptococcus pneumoniae/isolamento & purificação
Vírus/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (DNA, Bacterial); 0 (Nucleic Acids)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170328
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0173948


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[PMID]:28341167
[Au] Autor:Park BS; Kim SE; Park SH; Kim J; Shin KJ; Ha SY; Park J; Kim SE; Lee BI; Park KM
[Ad] Endereço:Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
[Ti] Título:Procalcitonin as a potential predicting factor for prognosis in bacterial meningitis.
[So] Source:J Clin Neurosci;36:129-133, 2017 Feb.
[Is] ISSN:1532-2653
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:We investigated the potential role of serum procalcitonin in differentiating bacterial meningitis from viral meningitis, and in predicting the prognosis in patients with bacterial meningitis. This was a retrospective study of 80 patients with bacterial meningitis (13 patients died). In addition, 58 patients with viral meningitis were included as the disease control groups for comparison. The serum procalcitonin level was measured in all patients at admission. Differences in demographic and laboratory data, including the procalcitonin level, were analyzed between the groups. We used the mortality rate during hospitalization as a marker of prognosis in patients with bacterial meningitis. Multiple logistic regression analysis showed that high serum levels of procalcitonin (>0.12ng/mL) were an independently significant variable for differentiating bacterial meningitis from viral meningitis. The risk of having bacterial meningitis with high serum levels of procalcitonin was at least 6 times higher than the risk of having viral meningitis (OR=6.76, 95% CI: 1.84-24.90, p=0.004). In addition, we found that high levels of procalcitonin (>7.26ng/mL) in the blood were an independently significant predictor for death in patients with bacterial meningitis. The risk of death in patients with bacterial meningitis with high serum levels of procalcitonin may be at least 9 times higher than those without death (OR=9.09, 95% CI: 1.74-47.12, p=0.016). We found that serum procalcitonin is a useful marker for differentiating bacterial meningitis from viral meningitis, and it is also a potential predicting factor for prognosis in patients with bacterial meningitis.
[Mh] Termos MeSH primário: Calcitonina/sangue
Meningites Bacterianas/diagnóstico
Meningite Viral/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Biomarcadores/sangue
Diagnóstico Diferencial
Feminino
Mortalidade Hospitalar
Seres Humanos
Masculino
Meningites Bacterianas/sangue
Meningites Bacterianas/mortalidade
Meningite Viral/sangue
Meningite Viral/mortalidade
Meia-Idade
Valor Preditivo dos Testes
Prognóstico
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 9007-12-9 (Calcitonin)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170326
[St] Status:MEDLINE



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