Meningitis Research Today is a free monthly online journal that collates and summarizes the latest research about Meningitis, including details on viral, bacterial, spinal, symptoms, treatment.

Relationship between Mycobacterium tuberculosis genotype and the clinical phenotype of pulmonary and meningeal tuberculosis.

Thwaites G, Caws M, Chau TT, D'Sa A, Lan NT, Huyen MN, Gagneux S, Anh PT, Tho DQ, Torok E, Nhu NT, Duyen NT, Duy PM, Richenberg J, Simmons C, Hien TT, Farrar J

Centre for Molecular Microbiology and Infection, Imperial College, Exhibition Rd., South Kensington, London, United Kingdom. guy.thwaites@btinternet.com

We used large sequence polymorphisms to determine the genotypes of 397 isolates of Mycobacterium tuberculosis from human immunodeficiency virus-uninfected Vietnamese adults with pulmonary (n = 235) or meningeal (n = 162) tuberculosis. We compared the pretreatment radiographic appearances of pulmonary tuberculosis and the presentation, response to treatment, and outcome of tuberculous meningitis between the genotypes. Multivariate analysis identified variables independently associated with genotype and outcome. A higher proportion of adults with pulmonary tuberculosis caused by the Euro-American genotype had consolidation on chest X-ray than was the case with disease caused by other genotypes (P = 0.006). Multivariate analysis revealed that meningitis caused by the East Asian/Beijing genotype was independently associated with a shorter duration of illness before presentation and fewer cerebrospinal fluid (CSF) leukocytes. Older age, fewer CSF leukocytes, and the presence of hemiplegia (but not strain lineage) were independently associated with death or severe disability, although the East Asian/Beijing genotype was strongly associated with drug-resistant tuberculosis. The genotype of M. tuberculosis influenced the presenting features of pulmonary and meningeal tuberculosis. The association between the East Asian/Beijing lineage and disease progression and CSF leukocyte count suggests the lineage may alter the presentation of meningitis by influencing the intracerebral inflammatory response. In addition, increased drug resistance among bacteria of the East Asian/Beijing lineage might influence the response to treatment. This study suggests the genetic diversity of M. tuberculosis has important clinical consequences.

Published 4 April 2008 in J Clin Microbiol, 46(4): 1363-8.
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Articles on Meningitis published 4 April 2008:

GeneXpert enterovirus assay: one-year experience in a routine laboratory setting and evaluation on three proficiency panels.   J Clin Microbiol, 46(4): 1510-3.

A prospective unblinded comparative evaluation of three assays for the detection of enteroviral RNA performed on 83 positive and 79 negative cerebrospinal fluid samples showed initial and resolved sensitivities of 90.4% and 98.8%, respectively, for the Cepheid GeneXpert enterovirus assay; 94.0% and 97.6%, respectively, for the Argene enterovirus consensus kit; and 100% and 100%, respectively, for an in-house real-time PCR. The initial and resolved specificities were 100% for all three assays. [Abstract] [Full-text]

Articles on Meningitis published 28 March 2008:

The influence of host and bacterial genotype on the development of disseminated disease with Mycobacterium tuberculosis.   PLoS Pathog, 4(3): e1000034.

The factors that govern the development of tuberculosis disease are incompletely understood. We hypothesized that some strains of Mycobacterium tuberculosis (M. tuberculosis) are more capable of causing disseminated disease than others and may be associated with polymorphisms in host genes responsible for the innate immune response to infection. We compared the host and bacterial genotype in 187 Vietnamese adults with tuberculous meningitis (TBM) and 237 Vietnamese adults with uncomplicated ... [Abstract] [Full-text]

Articles on Meningitis published 19 March 2008:

Multidrug-resistant Acinetobacter meningitis in neurosurgical patients with intraventricular catheters: assessment of different treatments.   J Antimicrob Chemother, 61(4): 908-13.

BACKGROUND: The treatment of multidrug-resistant Acinetobacter baumannii meningitis is a serious therapeutic problem due to the limited penetration of antibiotics into the CSF. We describe the clinical features and the outcome of a group of patients with nosocomial neurosurgical meningitis treated with different therapeutic options. METHODS: All patients with nosocomial post-surgical meningitis due to A. baumannii diagnosed between 1990 and 2004 were retrospectively reviewed. RESULTS: During ... [Abstract] [Full-text]

Articles on Meningitis published 18 March 2008:

Bacterial and fungal meningitis in patients with cancer.   Neurology, 70(12): 943-7.

OBJECTIVE: To analyze cases of bacterial and fungal meningitis in patients with cancer. METHODS: Retrospective chart review from 1993 to 2004 was performed of patients with cancer at our institution who had positive CSF bacterial or fungal culture. RESULTS: We identified 312 positive CSF cultures representing 175 unique presentations. Ninety-six cultures were deemed contaminants, leaving 79 cultures for analysis in 77 patients; 78% had prior neurosurgery. Organisms included 68% gram-positive ... [Abstract] [Full-text]

Articles on Meningitis published 3 March 2008:

Epidemiology and management of cryptococcal meningitis: developments and challenges.   Expert Opin Pharmacother, 9(4): 551-60.

The significance of cryptococcal infection as a cause of human disease has dramatically evolved in recent years. The objective of this study was to outline the worldwide significance of cryptococcosis and review developments in the management of cryptococcal meningitis. Cryptococcus neoformans var. grubii remains an important cause of disease, particularly in hosts with acquired immunosuppression. Cryptococcus gattii, on the other hand, infects hosts with seemingly normal immune systems and a ... [Abstract] [Full-text]

Articles on Meningitis published 28 February 2008:

Increased expression of tyrosine phosphatase SHP2 in experimental pneumococcal meningitis: correlation with tumor necrosis factor-alpha and cerebrospinal fluid pleocytosis.   J Child Neurol, 23(3): 287-92.

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Articles on Meningitis published 26 February 2008:

Regulation of immune response and inflammatory reactions against viral infection by VCAM-1.   J Virol, 82(6): 2952-65.

The migration of activated antigen-specific immune cells to the target tissues of virus replication is controlled by the expression of adhesion molecules on the vascular endothelium that bind to ligands on circulating lymphocytes. Here, we demonstrate that the adhesion pathway mediated by vascular cell adhesion molecule 1 (VCAM-1) plays a role in regulating T-cell-mediated inflammation and pathology in nonlymphoid tissues, including the central nervous system (CNS) during viral infection. The ... [Abstract] [Full-text]

Articles on Meningitis published 21 February 2008:

Stomatococcus mucilaginosus meningitis in a healthy 2-month-old child.   J Med Microbiol, 57: 382-3.

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