Meningitis Infections Research Articles

Insights into the role of Streptococcus oralis as an opportunistic pathogen in infectious diseases

Streptococcus oralis, belonging to the viridans group streptococci (VGS), has been considered a member of normal flora mainly inhabiting the oral cavity. However, more recently, there has been growing recognition of its role as a causative agent in various life-threatening infectious diseases such as infective endocarditis (IE) and meningitis. Additionally, the differences in the prevalence, clinical features, and prognosis of opportunistic infections between S. oralis and other VGS species have been addressed. Particularly the predominance of S. oralis in IE has drawn critical attention. In potentially fatal infections, clinical neglect of S. oralis as an instigating agent might significantly impede early diagnosis and treatment. Nevertheless, to date, the infectious diseases associated with S. oralis have not yet been comprehensively described. Therefore, this review will give an overview of infectious diseases caused by S. oralis to uncover its hidden role as an opportunistic pathogen.

Klebsiella in Wildlife: Clonal Dynamics and Antibiotic Resistance Profiles, a Systematic Review

Klebsiella spp. are a genus of Gram-negative, opportunistic bacteria frequently found in the flora of the mucosal membranes of healthy animals and humans, and in the environment. Species of this group can cause serious infections (meningitis, sepsis, bacteraemia, urinary tract infections, liver damage) and possible death in immunocompromised organisms (and even in immunocompetent ones in the case of hypervirulent K. pneumoniae) that are exposed to them. K. pneumoniae is part of the ESKAPE organisms, and so it is important to understand this genus in terms of multidrug-resistant bacteria and as a carrier of antibiotic resistance mechanisms. As it is a durable bacterium, it survives well even in hostile environments, making it possible to colonize all kinds of habitats, even the mucosal flora of wildlife. This systematic review explores the prevalence of Klebsiella spp. bacteria in wild animals, and the possibility of transmission to humans according to the One Health perspective. The isolates found in this review proved to be resistant to betalactams (blaTEM, blaOXA-48…), aminoglycosides (strAB, aadA2…), fosfomycin, tetracyclines, sulphonamides, trimethoprim, phenicols (catB4), and polymyxins (mcr4).

Eosinophilic Meningitis in a Patient With Early HIV Infection, Latent Syphilis and HSV-2 Meningitis

Abstract Eosinophilic meningitis is an unusual condition, particularly in patients with HIV infection or syphilis. The detection of herpes simplex virus (HSV)-2 and HIV-1 in cerebrospinal fluid from a patient with acute eosinophilic meningitis has not been previously reported. Herein, we report a case of a 26-year-old cisgender man newly diagnosed with HIV-1 infection and latent syphilis, presenting with headache and low-grade fever. He was diagnosed with both acute eosinophilic meningitis and HSV-2 meningitis, and his condition improved after treatment with acyclovir and penicillin. The compelling case indicates that HSV-2 meningitis may manifest concurrently with acute eosinophilia meningitis in patients coinfected with HIV and Treponema pallidum. Metagenomics next-generation sequencing plays an important role in identifying and further confirming pathogens responsible for central nervous system infections.

Stenotrophomonas maltophilia – A Threatening Nosocomial Pathogen

Abstract Stenotrophomonas maltophilia is a ubiquitous Gram-negative rod which has emerged as one of the major causes of nosocomial infections. It can cause pneumonia, septicemia, meningitis, urinary tract, and wound infections, and is associated with high mortality in immune-compromised patients. Pathogenesis in S. maltophilia infections is an outcome of multiple virulence factors, including outer membrane lipopolysaccharide, extracellular enzymes, porins, pilli, biofilm formation, motility, and small colony variants, among others. S. maltophilia shows high intrinsic and acquired resistance to all commonly used antibiotics, limiting the number of therapeutic choices. The aim of this review is to summarize the virulence factors, antibiotic resistance mechanisms, diagnosis, and treatment of S. maltophilia infections.

Optimising surgical outcomes for skull base epidermoid cysts

Introduction. Surgery for skull base epidermoid cysts (SBECs) has several inherent risks including aseptic meningitis and cerebrospinal fluid (CSF) malabsorption. Perioperative measures to reduce the likelihood of such complications have not been evaluated, and this study sought to compare outcomes before and after implementation of an institutional perioperative protocol in the management of SBECs. Methods. Review of a prospective database of surgically managed SBECs. Outcomes were compared before (2003-2008) and after (2010-2021) implementation of a perioperative protocol including intraoperative hyper-irrigation, prolonged course of postoperative steroids and aggressive management of CSF malabsorption. Results. 39 patients were included: 12 before and 27 after implementation of the protocol. The groups were similar with respect to mean age (p = 0.99), gender (p=0.29), surgical approach – most commonly retrosigmoid (p>0.99) and extent of resection – most commonly total or near total (p=0.64). The post protocol implementation group had a significantly lower rate of CSF diversion (p = 0.04). The overall rates of hydrocephalus (7% vs. 30%), CSF leak (19% vs. 33%), bacterial meningitis (15% vs. 33%) and mean length of stay (12 days vs. 49 days) were lower in the post-implementation group, although differences did not reach statistical significance. Rates of aseptic meningitis and cranial nerve palsies were similar. Conclusions. Our additional perioperative measures resulted in more favourable CSF dynamics with reduced need for CSF diversion and secondary consequences such as wound leaks and infective meningitis.

Effectiveness of Preoperative Antiseptic Preparation in Transnasal Skull Base Surgery: A Randomized Three-Arm Controlled Trial

Objective: Transnasal skull-base surgery is a complex and invasive procedure that involves the use of preoperative antiseptic preparations. However, evidence supporting their use in preventing postoperative infectious complications is limited. The aim of this study is to assess the efficacy of preoperative antiseptic techniques in reducing postoperative infectious complications within 30 days of surgery. Methods: A multicenter, prospective, randomized, single-blind, three-arm trial was conducted from February 2019 to October 2021. Participants were randomized to either of three antiseptic preparation techniques: external 0.9%NaCl nasal preparation, external 0.05% chlorhexidine gluconate, or intranasal irrigation with 80 mg of gentamicin added to 1000 ml of 0.9%NaCl plus external nasal preparation with chlorhexidine gluconate 0.05%. A total of 130 adults with skull-base pathologies were randomized, 12 were excluded before randomization for failure to meet inclusion criteria (n=9) or refusal to participate (n=3). We excluded patients with evidence of infection adjacent to the surgical site, allergies to preparation methods, those who underwent craniotomy during the same admission, and pediatric patients. Results: The mean age of participants was 43.26±14.45 years. Nine patients developed postoperative infections (meningitis, n=8; sinusitis, n=2). Among the factors studied, length of surgery (p=0.002), perioperative CSF diversion (p=0.01), chordoma (p=0.004), extended approach (p=0.026), and postoperative CSF leak (p=0.025) were significantly associated with postoperative infections. There were no clinically meaningful or significant differences in the studied intervention groups regarding postoperative infectious complications. Conclusion: Preoperative antiseptic techniques failed to prefer one application to prevent postoperative infectious complications in patients who underwent endoscopic transnasal skull-base surgery.

Infective Endocarditis by Listeria Species—A Systematic Review

Infective endocarditis (IE) is a disease associated with significant morbidity and mortality. It is more commonly caused by Gram-positive cocci, but Gram-positive bacilli may seldom cause the disease. Listeria monocytogenes is an aerobic Gram-positive coccobacillus and a foodborne and opportunistic pathogen most commonly causing gastrointestinal infections, even though bacteremia, sepsis, meningitis, and fetal infections may also occur. Listeria IE has rarely been described, with most reports being case reports or case series. Thus, the characteristics of this disease remain largely unknown. This systematic review aimed to present all published Listeria IE studies and describe their characteristics. A search of PubMed, Scopus, and the Cochrane Library for studies providing information on epidemiology, clinical findings, treatment, and outcome of Listeria IE cases was performed. A total of 54 studies containing data from 62 patients were included. Among all patients, 64.5% were male; the median age was 69 years. Among all patients, 54.8% had a history of a prosthetic valve. The aortic valve was the most commonly affected, followed by the mitral. Fever, heart failure, and embolic phenomena were the most commonly encountered clinical findings. The only isolated species was L. monocytogenes. Antimicrobial resistance was relatively low for aminopenicillins and aminoglycosides, the most commonly used antimicrobials for treating L. monocytogenes IE. Surgery was performed in 27.4% of patients. Mortality was 37.1%. Patients who survived were more likely to have had a prosthetic valve, to have necessitated transesophageal echocardiography for the diagnosis, to have mitral valve IE, and to have had surgical management; however, no factor was identified in a multivariate logistic regression model as an independent factor for overall mortality.

Molecular Identification and Virulence Genes Detection of Cronobacter Spp Isolated from Clinical Cases in Infants Under Two Years in Mosul City, Iraq

Cronobacter spp. are facultative-anaerobic non-spore forming Gram-negative bacteria, that are part of the Enterobacteriaceae family. They are opportunistic organisms that occasionally cause severe infections such as meningitis, necrotizing enterocolitis, and bloodstream infections in newborns and young children. There is a limited amount of information available about the diversity, pathogenicity, and virulence of Cronobacter species isolated from different sources. This study was conducted to isolate and identify Cronobacter spp from different clinical cases in children under two years in Mosul city and determine some virulence genes which are indicators for their pathogenicity. One hundred and fifty clinical specimens (diarrhea, blood and cerebrospinal fluid) were collected and cultured on Enterobacter sakazakii agar (HiCrome) and trypton soy agar. Eight Cronobacter spp were isolated and presumptively identified according to their morphological characteristics on selective media and confirmed by 16S rRNA gene sequencing and direct sequencing of ropB gene. PCR was used to amplify five potential virulence genes (cpa, hly, sip, zpx, and ompA) in order to determine their presence in our strains. The results revealed that all strains exhibited ompA and zpx, however, only four C. sakazakii strains contained cpa and hly genes. The sip gene was found in only two C. malonaticus strains. Lastly, ropB gene were detected in all Cronobacter spp isolated. Identification of Cronobacter from clinical specimens helps in understanding the sources and risks associated with these pathogens. By determining virulence genes, the study provides insights into how these bacteria cause disease which is crucial for developing targeted interventions and treatments. understanding the presence and characteristics of Cronobacter spp. in clinical cases informs diagnostic and treatment strategies, potentially leading to better patient outcomes.

The Relationship between the Classic Triad of Meningitis and Types of Meningitis

Meningitis is an inflammatory disease of the meninges caused by infection and non-infection. Based on WHO data for 2023, the CFR (Case Fatality Rate) for meningitis is 5.88%. In 2016 at the Southeast Asian level, Indonesia became the country with the highest mortality rate caused by meningitis. The classic triad of meningitis can assist in the early diagnosis of meningitis so that early management can be carried out to reduce mortality and morbidity if a cerebrospinal fluid examination is not possible immediately. Therefore, a study was conducted to determine the characteristics of meningitis patients, prevalence, and the relationship between the classic triad of meningitis and the incidence of infectious and non-infectious meningitis at Dr. Sardjito General Hospital Yogyakarta in 2017-2021. This study uses a cross-sectional method. The data taken is secondary data from 118 medical records of patients who have been treated. From the results, it was obtained that the highest characteristics and distribution were the age category 0-5 years (27.1%), male sex (51.7%), the most domicile outside DIY (54.2%), no/not yet school (36.4%) not/not yet working (38.1%), bacterial meningitis (39.0%), fever (89.8%), neck stiffness (78.8%). There is a significant relationship between the classic triad of meningitis and the type of meningitis (p-value 0.000). Among the three triads, it turned out that there was a solid relationship between the classic triad of meningitis and the type of infectious meningitis as indicated p-value by neck stiffness 0.000, fever 0.000, and headache 0.000.

Systemic meningococcal infection in children of the Arkhangelsk region: predictors of unfavorable course and outcome during different periods of observation

Invasive meningococcal infection remains a leading cause of death among infectious diseases in children.Aim. to investigate predictors of death in patients with invasive meningococcal infection during two periods of observation: 1991–2011 and 2012–2022.Materials and methods. A retrospective cohort study was conducted including 143 children aged 1,5 months to 17 years old, living in the Arkhangelsk region and having had invasive meningococcal infection. The study included two periods: 1991–2011 (N=93) and 2012–2022 (N=50). Groups of recovered and deceased patients were compared.Results. When admitted to the hospital meningococcal infection or bacterial meningitis was diagnosed in 25,5% of cases among deceased patients, and in 57,3% among survivors. More than half of the patients with an fatal outcome were not referred to the hospital after the first examination by a medical professional, unlike the recovered patients, of whom 68,8% were immediately referred to the hospital after examination. The majority of the recovered patients (82.3%) were transported to medical facilities providing specialized medical care. In the deceased group, treatment was initiated in non-specialized medical facilities in 74,5% of cases due to the distance from the regional center, where specialized care is provided. Throughout the observation period, the probability of death was higher in infants, patients with of septic shock, leukopenia, in cases requiring repeated visits by medical professional, and during initial therapy in nonspecialized medical organizations. Conclusion. The need to repeatedly seek healthcare, a different referral diagnosis, delays in receiving specialized medical care and the necessity for evacuation to the regional center for specialized care, all increase the probability of death and justify the advisability of specific prevention of meningococcal infection.

Infectious meningitis. Why are the leptomeninges preferentially involved? Electron microscopic insights.

In infectious meningitis, pathogens preferentially attack the leptomeninges (pia mater and arachnoid) rather than the pachymeninges (dura mater). This study aims to provide ultra-anatomical insights from our extensive collection of electron microscopy images and propose mechanisms, highlighting structures that favor the introduction, adherence, colonization, and proliferation of microorganisms leading to spinal meningitis. Over several years, we analyzed an extensive collection of transmission and scanning electron microscopy images of human spinal meninges captured in our laboratories. Upon examining 378 of those images, we identified potential sites for the iatrogenic or hematogenic introduction and adherence of microorganisms, as well as sites for their colonization and proliferation. These included the outer surface of the spinal dural sac, structures within the epidural space, and the spinal dural sac itself, which comprises compact dura mater with interwoven collagen fibers and tightly bound arachnoid cells. Also, the subdural (extra-arachnoid) compartment, consisting of fragile neurothelial cells prone to rupture under force, formed an acquired spinal subdural space, a new subarachnoid compartment, limited by arachnoid trabeculae, that surrounded the nerve roots and spinal cord and the pia mater. Macrophages, fibroblasts, mast cells, and plasma cells were also observed within the dura mater, arachnoid layer, arachnoid trabeculae, and pia mater. These images illustrate how the characteristics of the meningeal layers could contribute to bacterial adhesion and proliferation at various locations, inducing selective inflammation during (iatrogenic) spinal meningitis. In addition, the images help to explain why magnetic resonance imaging enhancement appears preferentially at specific sites.

The Clinical Manifestations, Risk Factors, Etiologies, and Outcomes of Adult Patients with Infectious Meningitis and Encephalitis: Single Center Experience.

(1) Background: Central nervous system (CNS) infections, including meningitis and encephalitis, are serious conditions which are associated with high morbidity and mortality. This study aims to identify the clinical manifestations, etiologies, and outcomes of meningitis and encephalitis in adult patients in Saudi Arabia, addressing the current gap in understanding these conditions within this population. (2) Methods: This is a single-center retrospective study which included all adult patients diagnosed with meningitis and encephalitis from March 2016 to May 2022. (3) Results: This study found that most cases of meningitis and encephalitis occurred due to unknown pathogens. Pretreatment with antibiotics prior to lumbar puncture (LP) was found in 71.2% of patients with meningitis. Altered mental status and seizures were common presenting symptoms among patients with encephalitis while altered mental status and fever were common among patients with meningitis. (4) Conclusions: Adherence to guidelines in treating meningitis and encephalitis and performing LPs in a timely manner are important. Establishing national biobanks with biological samples from patients suspected of having meningitis or encephalitis will significantly enhance our understanding of these conditions in Saudi Arabia.

Divergent effects of tumor necrosis factor (TNF) in sepsis: a meta-analysis of experimental studies

IntroductionExperimental studies in animals have yielded conflicting results on the role of Tumor Necrosis Factor (TNF) in sepsis and endotoxemia, with some reporting adaptive and others inappropriate effects. A meta-analysis of the available literature was performed to determine the factors explaining this discrepancy.MethodsThe study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The protocol was registered with PROSPERO (CRD42020167384) prior to data collection. PubMed and Embase were the databases queried. Risk of bias was evaluated using the SYRCLE Risk of Bias Tool. All animal studies investigating sepsis-related mortality and modified TNF signaling were considered eligible. The exclusion criteria were: lack of mortality data, 7-day mortality rates below 10% in both wild type and TNF-altered pathway animals, and absence of an English abstract. To determine the role of TNF according to the experimental protocol, three approaches were used: first an approach based on the statistical significance of each experiment, then the pooled mortality was calculated, and finally the weighted risk ratio for mortality was assessed.ResultsA total of 175 studies were included in the analysis, comprising a total of 760 experiments and involving 19,899 animals. The main species used were mice (77%) and rats (21%). The most common method of TNF pathway modulation was TNF pathway inactivation that was primarily associated with an inappropriate secretion of TNF. At the opposite, TNF injection was associated with an adaptive role of TNF. Lipopolysaccharide (LPS) injection was the most used stimulus to establish an infectious model (42%) and was strongly associated with an inappropriate role of TNF. Conversely, live bacterial models, especially the cecal ligation and puncture (CLP) model, pneumonia, meningitis, and gastrointestinal infection, were associated with an adaptive role. This was particularly evident for Listeria monocytogenes, Streptococcus pneumoniae.ConclusionThe role of TNF during infection varies depending on the experimental model used. Models that mimic clinical conditions, based on virulent bacteria that cause high mortality even at low inocula, demonstrated an adaptive role of TNF. Conversely, models based on LPS or low-pathogenic live bacteria, administered at doses well above physiological thresholds and combined with early antibiotic therapy, were associated with an inappropriate role.Graphical abstract

Cefotaxime Versus Ceftriaxone: A Comprehensive Comparative Review.

Cefotaxime and ceftriaxone are two prominent third-generation cephalosporin antibiotics, which are a class of antimicrobial agents with overlapping antibacterial spectra and therapeutic indications, commonly used in treating severe bacterial infections, including meningitis, sepsis, and respiratory tract infections. Despite their shared antibacterial coverage, these antibiotics differ significantly in their pharmacokinetic characteristics such as half-life, protein binding, and tissue penetration. This comprehensive review systematically compares the pharmacokinetic profiles, pharmacological attributes, clinical efficacy, and safety profiles of cefotaxime and ceftriaxone. It further highlights the importance of understanding the nuanced differences between cefotaxime and ceftriaxone, particularly in clinical settings such as intensive care units or during pediatric treatment, where rapid bactericidal action or prolonged drug activity might influence therapeutic outcomes. While their overlapping spectrums offer versatility, clinicians should consider these distinct pharmacokinetic attributes and associated clinical outcomes to guide optimal antibiotic selection.

Persistence of immunity in children aged 2 months and 7 months – 5 years old after primary immunization with 13-valent pneumococcal conjugate vaccine

Background: Pneumococcus is a common cause of pneumonia, meningitis, and other serious infections in children. The previous study has proved that the 13-valent pneumococcal conjugate vaccine (PCV13) has sufficient immunogenicity in children. The data on long-term persistence of immunity will help the follow-up development work of pneumococcal vaccines.Methods: Children who received the full vaccination course of the tested PCV13 in the previous clinical trial were enrolled again, and these who received other pneumococcal vaccines, or were infected with one or more serotypes of S. pneumoniae corresponding to PCV13 before enrollment were excluded. Participants were divided into four groups by age which is same as that of previous trial. The study lasted for 5 years, during which we measured pneumococcal antibodies of 13 serotypes included in PCV13 at particular points in time. Geometric mean concentrations (GMCs) and seropositive rates (the rate of IgG concentration ≥0.35 μg/mL) of antibodies against 13 serotypes were calculated.Results: For the participants aged 2 months, five years after primary vaccination, except for serotypes 3 and 4, seropositive rates were 100%. GMCs of IgG antibodies against 13 serotypes ranged from 0.733 to 15.160 μg/mL. All of the participants aged 7–11 months had the serotype-specific IgG concentration ≥0.35 μg/mL four years after primary vaccination with the exception of serotypes 3, 4, 6 A and 9 V. IgG GMCs were 0.753–11.031 μg/mL. All participants aged 12–23 months and 2–5 years old had the serotype-specific IgG concentration ≥0.35 μg/mL three or two years after primary vaccination respectively, except for serotype 3. IgG GMCs ranged from 0.815 to 13.111 μg/mL, and 0.684 to 12.282 μg/mL respectively.Conclusion: PCV13 was applied to the population aged 2 months and 7 months - 5 years old with a good immune persistence, providing more extensive evidence of long-term efficacy for that vaccine.Trial Registration: The trial was registered with ClinicalTrials.gov, number NCT06210737.

Phytochemical Composition, In Silico Molecular Docking Analysis and Antibacterial Activity of Lawsonia inermis Linn Leaves Extracts against Extended Spectrum Beta-Lactamases-Producing Strains of Klebsiella pneumoniae

Klebsiella pneumoniae is an opportunistic Gram-negative bacterium in the Enterobacteriaceae family associated with a wide range of diseases, such as pneumonia, bloodstream infections, meningitis and urinary tract infections. Infections caused by drug-resistant strains of Klebsiella pneumoniae pose a significant threat to the effectiveness of conventional antibiotics. Hence, this has led to the need to explore alternative antimicrobial therapies, especially natural products derived from plant sources. This study assessed the phytochemical composition and antibacterial properties and performed a molecular docking analysis of Henna leaves (Lawsonia inermis L.) extracts on strains of Klebsiella pneumoniae. Crude ethanol and methanol extracts of L. inermis L. were prepared at different concentrations (25, 50, 75 and 100 mg/mL) and tested on extended spectrum beta-lactamases (ESBLs)-producing strains of Klebsiella pneumoniae. Phytocompounds were identified using gas chromatography–mass spectrometry (GC-MS) and further subjected to virtual ligands screening with DataWarrior (v05.02.01) and a molecular docking analysis using AutoDock4.2 (v4.2.6). The active compounds of L. inermis L. were determined by the docking analysis, including phytochemical, physicochemical, pharmacokinetics and docking score. The GC-MS analysis identified 27 phytoconstituents, including ethyl acetate, sclareol, 2-[1,2-dihydroxyethyl]-9-[β-d-ribofuranosyl] hypoxanthine, α-bisabolol and 2-Isopropyl-5-methylcyclohexyl 3-(1-(4-chlorophenyl)-3-oxobutyl)-coumarin-4-yl carbonate. The 27 compounds were then screened for their physicochemical and pharmacokinetic properties. The results revealed that the methanol extracts at 100 mg/mL showed significantly higher (p < 0.05) zones of inhibition (13.7 ± 1.2 mm), while the ethanol extracts at 50 mg/mL were significantly lower (6.3 ± 0.6 mm) compared to all the other treatments. The docking analysis revealed that out of the 27 compounds identified, only twelve (12) compounds have a drug-likeness activity. The 12 compounds were further subjected to docking analysis to determine the binding energies with the CTX-M protein of Klebsiella pneumoniae. Only one compound [CID_440869; (2-[1,2-dihydroxyethyl]-9-[β-d-ribofuranosyl] hypoxanthine)] had the best binding energy of −9.76 kcal/mol; hence, it can be considered a potentially suitable treatment for infections caused by ESBLs-producing strains of Klebsiella pneumoniae. This study has demonstrated that L. inermis L. extracts have antibacterial effects. Further research could explore the potential antimicrobial applications of L. inermis L. extracts to many bacterial strains.

Risk factors associated with meningitis outbreak in the Upper West Region of Ghana: A matched case-control study.

The Northern part of Ghana lies within the African meningitis belt and has historically been experiencing seasonal meningitis outbreaks. Despite the continuous meningitis outbreak in the region, the risk factors contributing to the occurrence of these outbreaks have not been clearly identified. This study, therefore, sought to describe the clinical characteristics and possible risk factors associated with meningitis outbreaks in the Upper West Region (UWR). A 1:2 matched case-control study was conducted in May-December 2021 to retrospectively investigate possible risk factors for meningitis outbreak in the UWR of Ghana between January and December 2020. Cases were persons with laboratory confirmed meningitis, and controls were persons of similar age and sex without meningitis living in the same house or neighborhood with a confirmed case. Both primary and secondary data including clinical, socio-demographic and laboratory information were collected and entered on standard questionnaires. Data was analyzed using descriptive statistics and conditional logistic regression. Meningitis cases were mostly due to Streptococcus pneumoniae (67/98; 68.37%), followed by Neisseria meningitides serogroup X (27/98; 27.55%). Fever occurred in 94.03% (63/67) of Streptococcus pneumoniae cases and 100% in both Neisseria meningitidis serogroup X (27/27) and Neisseria meningitidis serogroup W groups (3/3). CSF white cell count was significantly associated with the causative agents of meningitis. Conditional logistic regression analysis showed that, passive exposure to tobacco [AOR = 3.65, 95%CI = 1.03-12.96], bedrooms with 3 or more people [AOR = 4.70, 95%CI = 1.48-14.89] and persons with sore throat infection [AOR = 8.97, 95%CI = 2.73-29.43] were independent risk factors for meningitis infection. Headache, fever and neck pain continue to be the most common symptoms reported by meningitis patients. Education and other preventive interventions targeting exposure to tobacco smoke and crowded rooms would be helpful in reducing meningitis outbreaks in the Upper West Region of Ghana.

From Lab to Clinic: The Potential of Nanobubble Ozone Stored in Liposome with Pantothenic Acid (NOSLIP) in Treating Vaginal Infections with Long-lasting Effectiveness

Every year, 5-10 million women apply to various centers for sexually transmitted diseases due to infectious vaginitis (1). The three most notable causes of infectious vaginitis are bacterial vaginosis (BV), trichomoniasis, and vulvovaginal candidiasis (VVC). BV and VVC, which are endogenous genital infections, are the agents most responsible for the etiology of vaginal discharge (2). The most common symptoms of infectious vaginitis are vaginal discharge, itching, and a burning sensation. However, some cases are asymptomatic and are untreated (3). Group B streptococci (Streptococcus agalactiae; GBS) are gram-positive encapsulated bacteria that can colonize the intestinal and vaginal flora in 10-30% of healthy adults (4). Streptococcus agalactiae causes serious infections such as meningitis, sepsis, skin and soft tissue infections, pneumonia, urinary tract infections, and postpartum endometritis in newborns, pregnant women and adults with underlying diseases (4-6). Ozone is a highly reactive form of oxygen composed of three oxygen atoms. It is generated through the interaction of UV light and high-pressure diatomic oxygen. Ozone is widely acknowledged for its potent antibacterial properties due to its strong oxidative nature. Ozone therapy has garnered growing interest in recent years and is widely recognized for its beneficial impact on infection, reperfusion injury, cancer, and dental caries (7-8). At present, ozone therapy is an emerging approach in the clinical management of vaginitis. The medical ozone therapy device utilizes an ozone generator to produce a specific concentration of ozone, which is subsequently combined with filtered tap water to create ozonated water. Ozone and reactive chemicals exist in a liquid state and have a significant impact on vaginal sterilization (9).

Dynamic PET reveals compartmentalized brain and lung tissue antibiotic exposures of tuberculosis drugs

Tuberculosis (TB) remains a leading cause of death, but antibiotic treatments for tuberculous meningitis, the deadliest form of TB, are based on those developed for pulmonary TB and not optimized for brain penetration. Here, we perform first-in-human dynamic 18F-pretomanid positron emission tomography (PET) in eight human subjects to visualize 18F-pretomanid biodistribution as concentration-time exposures in multiple compartments (NCT05609552), demonstrating preferential brain versus lung tissue partitioning. Preferential, antibiotic-specific partitioning into brain or lung tissues of several antibiotics, active against multidrug resistant (MDR) Mycobacterium tuberculosis strains, are confirmed in experimentally-infected mice and rabbits, using dynamic PET with chemically identical antibiotic radioanalogs, and postmortem mass spectrometry measurements. PET-facilitated pharmacokinetic modeling predicts human dosing necessary to attain therapeutic brain exposures. These data are used to design optimized, pretomanid-based regimens which are evaluated at human equipotent dosing in a mouse model of TB meningitis, demonstrating excellent bactericidal activity without an increase in intracerebral inflammation or brain injury. Importantly, several antibiotic regimens demonstrate discordant activities in brain and lung tissues in the same animal, correlating with tissue antibiotic exposures. These data provide a mechanistic basis for the compartmentalized activities of antibiotic regimens, with important implications for developing treatments for meningitis and other infections in compartments with unique antibiotic penetration.

Comparison of phenolic total ethanol extract of 70% and 96% carrot leaves and antibacterial activity test against Staphylococcus aureus

Carrots (Daucus carota L.) are a plant that is widely used by the community, especially the tubers, while the leaves are not widely used and are only used as waste or animal feed. Carrot leaves contain secondary metabolites such as phenols, flavonoids, tannins, saponins, alkaloids, and steroids. Phenolic compounds are secondary metabolite compounds that are most abundant in nature. This compound can be used in the pharmaceutical world as an alternative treatment from natural ingredients, one of which is as an antibacterial. Staphylococcus aureus bacteria can cause skin infections such as boils. If it enters the bloodstream, it can cause meningitis or lung infections. This study aims to determine the total phenolic content in carrot leaves extracted with 70% and 96% ethanol solvents and to determine their antibacterial activity against Staphylococcus aureus. Carrot leaf extract is obtained by the maceration method. Total phenolic content was calculated using the Follin-Ciocalteau method. The antibacterial activity test was carried out using an excellent method. The research results showed that the yield of 70% ethanol extract was 17.235% and 96% ethanol extract was 16.053%. The results of testing the phenolic content of 70% ethanol extract of carrot leaves were 44.586 mgGAE/g and the phenolic content of 96% ethanol extract was 34.939 mgGAE/g. The results of the antibacterial activity test of 70% ethanol extract of carrot leaves had an average measurement of the inhibition zone at concentrations of 20%, 30% and 40%, namely 0.175 cm, 0.226 cm and 0.274 cm.