Epidemiological Features of Central Nervous System (CNS) Infections in Taiwan and Molecular Investigation of CNS Infections of Unknown Cause

Abstract

Epidemiological Features of Central Nervous System (CNS) Infections in Taiwan and Molecular Investigation of CNS Infections of Unknown Cause Chien-Chin (Kevin) Hsu In this thesis, I explore the epidemiological features of CNS infections using a population-based dataset and analyze CSF samples from patients with meningitis or encephalitis of unknown cause using molecular methods. In the second chapter, I review the literature on the epidemiology of meningitis and encephalitis, and current diagnostic approaches, focusing on the strengths and limitations of various diagnostic methods. In the third chapter, I investigate the causes of meningitis and encephalitis using a population-based dataset from the National Health Insurance Research Dataset (NHIRD) from Taiwan, representing the interval from 1996 to 2008. The analysis assesses differences in the disease between known and unknown cause groups in terms of incidence, demographic features, seasonal and geographic distribution. In the fourth chapter, I analyze CSF samples from patients with meningitis or encephalitis of unknown cause using a tiered molecular approach to discover the undetected or novel pathogens; techniques used include MassTag PCR, DNA microarrays and high-throughput pyrosequencing. I conclude the thesis in the fifth chapter, summarizing and highlighting the main results of these studies.