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Journal Article 2007; 28(Suppl 3): 2-4 PubMed PMID: 18030261 Citation  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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Journal Article 2007; 28(Suppl 4): 18-19 PubMed PMID: 18030252 Citation  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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Journal Article 2007; 28(5): 652-658 PubMed PMID: 17984956 Citation  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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Letter 2007; 28(Suppl 2): 45-46 PubMed PMID: 17558380 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Ceftriaxone:therapeutic use, Child, Child, Preschool, Chloramphenicol:therapeutic use, Disease Notification, Humans, Meningitis, Meningococcal:drug therapy, Population Surveillance, Refugees, Sudan:epidemiology, Trea.   

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Journal Article 2007; 28(Suppl 2): 38-39 PubMed PMID: 17558378 Citation  Keywords:  Anti-Infective Agents:therapeutic use, Brain Diseases:drug therapy, Candidiasis:drug therapy, Cross Infection:drug therapy, Drug Resistance, Microbial, Fluconazole:therapeutic use, Humans, Meningitis:drug therapy, Pseudomonas Infections:drug therapy, Stap.   

: Within last 15 years, analyzing patterns of etiology and resistance in organisms causing neuroinfections, emergence of resistance has been observed in Slovakia in S. haemolyticus to teicoplanin (11%), Ps. aeruginosa and A. baumannii to meropenem (20%) and Candida spp. (non-albicans Candida spp.) to fluconazol (20%). There are no new antibiotics against carbapenem resistant Ps. aeruginosa and Acinetobacter baumannii....

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Journal Article 2007; 28(Suppl 2): 34-35 PubMed PMID: 17558376 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Child, Child, Preschool, Cross Infection:drug therapy, Humans, Infant, Infant, Newborn, Meningitis, Bacterial:drug therapy, Neurosurgical Procedures:adverse effects, Postoperative Complications:drug therapy, Retrospe.   

: Analysing 101 cases of nosocomial meningitis due to staphylococci other than S. aureus within last 15 years, coagulase negative staphylococci represented the commonest pathogen. Major risk factor for staphylococcal meningitis was prior neurosurgery, mainly ventriculoperitoneal shunt insertion. Ten of 101 cases were caused by glycopeptide intermediate resistant strains in patients pretreated with multiple combination of antibiotics including vancomycin and shunt exchanges: 76% of strains were also oxacillin resistant....

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Journal Article 2007; 28(Suppl 2): 32-33 PubMed PMID: 17558375 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Cross Infection:drug therapy, Enterococcus faecalis:pathogenicity, Gram-Positive Bacterial Infections:complications, Humans, Infant, Newborn, Infant, Very Low Birth Weight, Meningitis, Bacterial:drug therapy, Neurosu.   

: Enterococcal meningitis is a rare complication of neurosurgical procedure or high technology treatment of children and occurs mainly imunocompromised neonates with very low birth weight, severe prematurity and complicates sometime ventriculoperitoneal shunt insertion or perinatal trauma. E. faecalis caused 10 nosocomial meningitis and all strains were susceptible to vancomycin and chloramphenicol, and in our database 90% also to gentamicin and ampicillin. Mortality in our group of 10 children was 20% what is insignificantly higher than overall mortality in the whole cohort of meningitis within last 15 years in our database (15.1%). Early empiric therapy should include also ampicillin or vancomycin, if enterococcal etiology is suspected....

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Journal Article 2007; 28(Suppl 2): 30-31 PubMed PMID: 17558374 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Cross Infection:drug therapy, Humans, Hydrocephalus:etiology, Infant, Newborn, Language Development Disorders:etiology, Meningitis, Bacterial:drug therapy, Rare Diseases, Retrospective Studies, Streptococcal Infectio.   

: Streptococcus agalactiae is a rare cause of neonatal meningitis in the era of peripartum prophylaxis with prophylaxis with ampicillin in colonized/infected mothers. However 5 cases of meningitis among 171 cases of pediatric nosocomial meningitis database within last 15 years occurred. All 5 children were neonates (one VLBW and early gestation newborn), 2 after neurosurgery. All 5 cases were successfully cured with a combination of cefotaxim (or ceftazidim) plus aminoglycosides, in one case also with addition of vancomycin or ampicillin. However 3 of 5 cured patients had neurologic sequellae, two of them reversible hydrocephalus and in speech retardation....

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