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Bacterial meningitis after craniocerebral trauma in the community.

Holeckova K, Kolenova A, Lesnakova A, Steno J, Streharova A, Kisac P, Beno P, Kalavsky M, Sramka M, Ondrusova A, Benca J, Seckova S, Sladeckova V, Bartkovjak M, Bukovinova P, Hvizdak F, Lengyel P, Svabova V, Findova L, Kutna K, Deadline J, Johnson M, Namulanda V, Juma O, Okoth V, Kovac M, Rudinsky B, Bauer F, Karvaj M, Sabo I, Huttova M, Kenderessy P, Nosko J, Paulikova T, Rusnak R, Povinsky J, Galla S.

Journal Article 2007; 28(Suppl 3): 12-13 PubMed PMID: 18030265 Keywords: Alcohol-Related Disorders:complications, Anti-Bacterial Agents:therapeutic use, Bacteria:classification, Brain Damage, Chronic:etiology, Cohort Studies, Community-Acquired Infections:etiology, Craniocerebral Trauma:complications, Humans, Meningitis, Bacte.

: Craniocerebral trauma is one of major risk factors for development of meningitis. We reviewed 30 cases of bacterial meningitis occurring in community after craniocerebral trauma. Alcohol abuse was significant risk factor occurring in trauma patients with meningitis present in 50% in our cohort (p=0.0001). The most common pathogen in posttraumatic meningitis was Str. pneumoniae (90% vs. 33.8%, p=0.0001). However mortality was very low, only 5% probably because of early diagnosis and treatment of patients at risk for bacterial meningitis but neurologic sequellea were significantly more common (p=0.00001) in patients after craniocerebral trauma....

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Meningitis in tropics--what is the optimal initial therapy?

Benca J, Duong L, Shahum A, Ondrus A, Koleno A, Bartkovjak M, Sladecko V, Muli J.

Comparative Study 2007; 28(Suppl 3): 10-11 PubMed PMID: 18030264 Keywords: Africa South of the Sahara, Aged, Aged, 80 and over, Anti-Infective Agents:classification, Child, Child, Preschool, Community-Acquired Infections:therapy, European Union, Humans, Infant, Newborn, Meningitis, Bacterial:therapy, North America, South America.

: Risk factors, etiology, epidemiology and initial therapy of community acquired meningitis in tropics is briefly reviewed....

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Comparison of postsurgical and community acquired bacterial meningitis--analysis of 372 cases within a nationwide survey.

Streharova A, Benca J, Holeckova K, Balik J, Sula I, Lesnakova A, Luzinsky L, Pavlikova Z, Adamkovicova E, Spilakova N, Kacunova B, Dovalova V, Kisac P, Beno P, Kalavsky E, Sramka M, Benka J, Ondrusova A, Seckova S, Sladeckova V, Kolenova A, Bartkovjak M, Bukovinova P, Hvizdak F, Lengyel P, Bielova M, Wiczmandyova O, Svabova V, Findova L, Kutna K, Deadline J, Diana E, Krumpolcova M, Kiwou M, Steno J, Stankovic I, Bauer F, Kovac M, Huttova M, Taziarova M, Luzica R, Saniova B, Rudinsky B, Sabo I, Karvaj M, Johnson M.

Comparative Study 2007; 28(Suppl 3): 7-9 PubMed PMID: 18030263 Keywords: Community-Acquired Infections:complications, Cross Infection:complications, Humans, Meningitis, Bacterial:etiology, Neurosurgical Procedures:adverse effects, Postoperative Complications:microbiology, Risk Factors, Slovakia:epidemiology, Statistics, Nonpar.

: The aim of this study was to assess if differences in etiology and risk factors among 372 cases of bacterial meningitis acquired after surgery (PM) or in community (CBM) have impact on outcome of infected patients. Among 372 cases of bacterial meningitis within last 17 years from 10 major Slovak hospitals, 171 were PM and 201 CBM. Etiology, risk factors such as underlying disease, cancer, diabetes alcoholism, surgery, VLBW, ENT infections, trauma, sepsis were recorded and mortality, survival with sequellae, therapy failure were compared in both groups. Significant differences in etiology and risk factors between both groups were reported. Those after neurosurgery had more frequently Coagulase negative staphylococci (p<0.001), Enterobacteriaceae (p=0.01) and Acinetobacter baumannii (p=0.0008) isolated from CSF and vice versa Streptococcus pneumoniae (p<0.001), Neisseria meningitis (p<0.001) and Haemophillus influenza (p=0.0009) were more commonly isolated from CSF in CBM. Neurosurgery (p<0.001), sepsis (p=0.006), VLBW neonates (p=0.00002) and cancer (p=0.0007) were more common in PM and alcohol abuse (p<0.001) as well as otitis/sinusitis (p<0.001) and Roma ethnic group (p=0.001) in CAM. Initial treatment success was significantly more frequently observed among CAM (p<0.001) but cure after modification was more common in PM (p=0.002). Therefore outcome in both groups was similar (14.6% vs. 12.4%, p=NS)....

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Antimicrobial susceptibility of cerebrospinal isolates from patients with meningitis.

Liskova A, Benca J, Kalavsky E, Kovac M, Rudinsky B, Ondrusova A, Kiwou M.

Journal Article 2007; 28(Suppl 3): 5-6 PubMed PMID: 18030262 Keywords: Anti-Bacterial Agents:therapeutic use, Cefotaxime:therapeutic use, Chloramphenicol:therapeutic use, Drug Resistance, Microbial, Haemophilus Infections:complications, Haemophilus influenzae:drug effects, Humans, Meningitis, Bacterial:cerebrospinal fluid, M.

: Str. pneumoniae isolates were susceptible to penicillin, all to also ofloxacin and chloramphenicol and cefotaxim and 39 (100%) to cotrimoxazol. Concerning S. aureus, all isolates 22 were susceptible to oxacillin and chloramphenicol, and 21 also to cotrimoxazol. All N. meningitidis isolates but one-10 of all were susceptible to penicillin, all to cefotaxim, chloramphenicol and cotrimoxazol. All H.influenzae isolates were susceptible to ampicillin and chloramphenicol, as well as to ofloxacin and cotrimoxazol. Those surprisingly high susceptibilities to rather "old" antibiotics may be explained by low antibiotic consumption, accessibility and therefore low usage which is a key promoter of resistance both in community and hospital....

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Predictors of inferior outcome in community acquired bacterial meningitis.

Streharova A, Krcmery V, Kisac P, Kalavsky E, Holeckova K, Lesnakova A, Luzinsky L, Adamkovicova E, Pavlikova Z, Spilakova N, Kacunova B, Dovalova V, Wiczmandyova O, Spanik S, Liskova A, Chovancova D, Kovac M, Ondrusova A, Bauer F, Benca J, Rudinsky B, Sramka M, Kralova J, Krsakova J, Krumpolcova M, Findova L, Svabova V, Sladeckova V, Seckova S, Saniova J, Pavlicova B, Taziarova M, Bukovinova P, Kolenova A, Horvathova E, Hvizdak F, Luzica R, Rolnikova B, Bocakova A, Grey E, Bielova M, Huttova M, Sabo I, Jalili N.

Journal Article 2007; 28(Suppl 3): 2-4 PubMed PMID: 18030261 Keywords: Alcoholism:complications, Brain Damage, Chronic:etiology, Brain Injuries:complications, Chi-Square Distribution, Community-Acquired Infections:complications, Diabetes Mellitus, Gram-Negative Bacterial Infections:complications, Humans, Meningitis, Bacteria.

: The aim of this study was to assess mortality and sequellae within cases from Nationwide survey of community acquired meningitis and identify risk factors for inferior outcome. Risk factors such as underlying disease (diabetes mellitus, cancer, trauma, neonatal age, splenectomy, alcoholism, sepsis, other infections), etiology, clinical symptoms and outcome (death, improvement and cured after modifications of ATB therapy, cured without change of therapy, cured with neurologic sequellae) were recorded and analysed with univariate analysis (chi2 or t test for trends, CDC Atlanta 2004). Analysing risk factors for inferior outcome (death or cured with neurologic sequellae), we compared patients who died or survived with neurologic sequellae to all patients with community acquired bacterial meningitis. Univariate analysis showed that trauma (p<0.05), alcohol abuse (p<0.05), diabetes, S. aureus (p<0.05) and gram-negative etiology (A. baumannii, Ps. aeruginosa or Enterobacteriaceae) (36% vs. 11,9%, p<0.05) were predicting inferior outcome. Analysing risk factors for treatment failure (death or failed but cured after change of antibiotic treatment) prior sepsis (34.1% vs. 13.9%, p<0.01) and gram-negative etiology (25% vs. 11.9%, p<0.02) were statistically significant predictors of treatment failure. Neisseria meningitis had less failures (p<0.05). Concerning infection associated mortality again diabetes mellitus (p<0.05), alcoholism (p<0.05) staphylococcal and gram-negative etiology (p<0.05) were significant predictors of death. N. meningitis had surprisingly less treatment failures (appropriate and rapid initial therapy). Neurologic sequellae were more common in patients with alcohol abuse (p<0.05), craniocerbral trauma (p<0.05) and less common in meningitis with pneumococcal etiology (p<0.05)....

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Meningitis in excessive alcohol consumers acquired in the community.

Benca J, Bartosovic I, Kalavsky E, Kisac P, Hanobik F, Bielova M, Duong L.

Journal Article 2007; 28(Suppl 4): 18-19 PubMed PMID: 18030252 Keywords: Adult, Alcoholism:complications, Community-Acquired Infections:epidemiology, Health Surveys, Humans, Male, Meningitis, Bacterial:complications, Meningitis, Pneumococcal:complications, Risk Factors, Slovakia:epidemiology, Treatment Outcome,.

: Etiology, risk factors, treatment and outcome of 21 cases of bacterial meningitis diagnosed in excessive alcohol consumers within 5 years of national community acquired meningitis survey in Slovakia is reported....

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Differential diagnosis of Charcot arthropathy and osteomyelitis.

Soysal N, Ayhan M, Guney E, Akyol A.

Case Reports 2007; 28(5): 556-559 PubMed PMID: 17994005 Keywords: Aged, Amoxicillin-Potassium Clavulanate Combination:therapeutic use, Anti-Bacterial Agents:therapeutic use, Arthropathy, Neurogenic:complications, Blood Sedimentation, Diabetic Foot:complications, Diagnosis, Differential, Forefoot, Human:diagnostic imagin.

: Foot problems are common causes of morbidity in patients with diabetes mellitus. Foot ulcers are the leading cause of hospitalization in diabetic patients. Bones may be involved in two different clinical conditions: osteomyelitis and Charcot osteoarthropathy. Osteomyelitis usually develops by spreading from contiguous soft tissue to underlying bone. Charcot foot is deformation of foot as a result of muscle athrophy, bone and joint structure changes in a joint as a secondary complication of neuropathy. To distinguish bone infection from non-infectious bone disorders as in Charcot joint may be difficult, especially if there is no skin ulceration. So, the mere absence of skin ulcers does not exclude the diagnosis of osteomyelitis....

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An experimental Staphylococcus aureus meningitis model for investigating induced leptomeningeal and subpial inflammation in rats: a transmission electron microscopy study.

Guzel A, Er U, Tatli M, Aluclu M, Ozekinci T, Nergiz Y, Ahishali B, Aktas G, Kavak V, Nergiz S, Ozkan U, Satici O.

Journal Article 2007; 28(5): 652-658 PubMed PMID: 17984956 Keywords: Animals, Arachnoid:microbiology, Brain:microbiology, Disease Models, Animal, Meninges:microbiology, Meningitis, Bacterial:microbiology, Pia Mater:microbiology, Random Allocation, Rats, Rats, Sprague-Dawley, Spinal Cord:microbiology, Staphylococcus aureus:.

OBJECTIVE: To evaluate leptomeningeal and subpial inflammatory responses of experimental Staphylococcus aureus bacteriemia following intraperitoneal and intravenous applications and to compare the inflammatory reactions in different regions of central nervous system.

MATERIAL AND METHODS: Forty anesthetized rats were divided into four groups equal in number. The rats in group-I were given 1 ml suspension of Staphylococcus aureus intraperitoneally. Group-II was the control group of group I; it was administrated 1 ml 0.9% NaCl in water intraperitoneally. The rats in group-III were given the same amount of bacteria intravenously. Group IV was the control group of the group-III; it was administrated 1 ml 0.9% NaCl solution intravenously. The rats were sacrificed on the 21st day. Inflammatory changes of different regions of the central nervous system were examined under transmission electron microscopy. Statistical analysis was done by using variance analysis, Bonferroni, Tamhane post hoc, Student's t and univariate tests.

RESULTS: Thoracic and occipital regions were the most vulnerable zones. Increasing of collagen tissue was the most detected inflammatory change.

CONCLUSION: This experimental model can be used for inducing subpial and leptomeningeal inflammations and it may be developed for investigations of pathogenesis of leptomeningitis during systemic infections....

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