Cerebrospinal fluid procalcitonin predicts Gram-negative bacterial meningitis in patients with empiric antibiotic pretreatment

Abstract The source of the abnormally high concentration of lactate in the cerebrospinal fluid in patients with bacterial meningitis is not known. It may represent a bacterial metabolite. To determine whether cerebrospinal fluid possesses appropriate substrates to support the growth of pathogenic aerobic bacteria, three Gram-positive and nine Gram-negative bacteria were separately inoculated in pooled normal cerebrospinal fluid. After incubation for 24 h, all Gram-positive bacteria increased lactate, eight Gram-negative bacteria decreased lactate, and one Gram-negative bacteria failed to significantly change the lactate concentration. We conclude that lactate produced in cerebrospinal fluid in patients with aerobic bacterial meningitis is not necessarily a bacterial metabolite.

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Cerebrospinal fluid endotoxin concentrations in gram-negative bacterial meningitis

The Journal of Pediatrics ◽

10.1016/s0022-3476(76)80004-2 ◽

1976 ◽

Vol 88 (4) ◽

pp. 553-556 ◽

Cited By ~ 32

Author(s):

Nolan S. Berman ◽

Stuart E. Siegel ◽

Ronald Nachum ◽

Allen Lipsey ◽

John Leedom

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Gram Negative

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Rapid diagnosis of gram-negative bacterial meningitis by the Limulus endotoxin assay

Journal of Clinical Microbiology ◽

10.1128/jcm.7.1.12-17.1978 ◽

1978 ◽

Vol 7 (1) ◽

pp. 12-17 ◽

Cited By ~ 1

Author(s):

J H Jorgensen ◽

J C Lee

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Antibiotic Therapy ◽

Pneumococcal Meningitis ◽

Rapid Diagnosis ◽

Acute Bacterial Meningitis ◽

Gram Negative ◽

Bacterial Cultures ◽

Limulus Amoebocyte Lysate ◽

Gram Negative Organisms

The Limulus amoebocyte lysate endotoxin assay was evaluated as a method for rapid diagnosis of acute bacterial meningitis in a series of 305 patients. The results of Limulus assays on cerebrospinal fluid (CSF) samples from these patients were compared with the results for each patient of routine bacterial cultures and Gram stains. Positive Limulus tests were obtained on initial CSF specimens from 84% of patients with culture-proven bacterial meningitis, including all patients with meningitis due to gram-negative organisms. Initial Gram-stained smears revealed the presence of organisms in 68% of the patients. One patient with pneumococcal meningitis had a weakly positive Limulus assay, whereas patients with meningitis due to other gram-positive organisms, those with aseptic meningitis, or patients without meningitis had negative CSF Limulus tests. The Limulus assay also demonstrated the persistence of endotoxin in the CSF of certain patients during antibiotic therapy, especially patients with Haemophilus influenzae meningitis. The Limulus test proved to be a rapid, reliable indicator of the presence of gram-negative organisms in the CSF of patients suspected of acute bacterial meningitis.

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An unusual Case of Meningitis

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2015/262479 ◽

2015 ◽

Vol 26 (3) ◽

pp. e62-e64 ◽

Cited By ~ 5

Author(s):

Eric DR Pond ◽

Sameh El-Bailey ◽

Duncan Webster

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Lumbar Puncture ◽

Pasteurella Multocida ◽

Unusual Case ◽

Definitive Treatment ◽

Gram Negative ◽

Level Of Consciousness ◽

Low Glucose ◽

Animal Exposure

Pasteurella multocidais a rare cause of bacterial meningitis. A 56-year-old man with several pets developed a profoundly decreased level of consciousness following left tympanomastoidectomy. Lumbar puncture produced cerebrospinal fluid with the typical findings of meningitis (low glucose, high protein, high leukocytes). Cultures from the cerebrospinal fluid and a swab of the left ear revealed Gram-negative coccobacillus identified asP multocida. The organism was sensitive to ceftriaxone, ampicillin and penicillin, and a 14-day course of intravenous penicillin was used as definitive treatment, resulting in full recovery. Although rare,P multocidashould be considered as a potential cause of meningitis in patients with animal exposure, particularly in the setting of recent cranial surgery.

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The Causative Organisms of Bacterial Meningitis and their Antimicrobial Resistance Profiles in Iranian Children in 2011-2016

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666181123130101 ◽

2020 ◽

Vol 20 (2) ◽

pp. 229-236

Author(s):

Sepideh Keshavarz Valian ◽

Shima Mahmoudi ◽

Babak Pourakbari ◽

Maryam Banar ◽

Mohammad Taghi Haghi Ashtiani ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Bacterial Meningitis ◽

Medical Center ◽

Blood Cultures ◽

Gram Positive ◽

Gram Negative ◽

Number Of Patients ◽

Resistance Patterns ◽

Iranian Children ◽

Surgery Department

Objective: The study aimed to describe the identity and antimicrobial resistance patterns of the causative agents of bacterial meningitis in children referred to Children’s Medical Center (CMC) Hospital, Tehran, Iran. Methods: This retrospective study was performed at CMC Hospital during a six-year period from 2011 to 2016. The microbiological information of the patients with a diagnosis of bacterial meningitis was collected and the following data were obtained: patients’ age, sex, hospital ward, the results of CSF and blood cultures, and antibiotic susceptibility profiles of isolated organisms. Results: A total of 118 patients with bacterial meningitis were admitted to CMC hospital. Sixty-two percent (n=73) of the patients were male. The median age of the patients was ten months (interquartile range [IQR]: 2 months-2 years) and the majority of them (n=92, 80%) were younger than two years of age. The highest number of patients (n=47, 40%) were admitted to the surgery department. Streptococcus epidermidis was the most frequent isolated bacterium (n=27/127, 21%), followed by Klebsiella pneumoniae (n=20/127, 16%), and Staphylococcus aureus (n=16/127, 12.5%). Blood culture was positive in 28% (n=33/118) of patients. Ampicillin-sulbactam and imipenem were the most effective antibiotics against Gram-negative bacteria isolated from CSF cultures. In the case of Gram-positive organisms, ampicillinsulbactam, vancomycin, and linezolid were the best choices. Imipenem was the most active drug against Gram-negative blood pathogens. Also, ampicillin and vancomycin had the best effect on Gram-positive bacteria isolated from blood cultures. Conclusion: Results of this study provide valuable information about the antibiotic resistance profiles of the etiologic agents of childhood meningitis, which can be used for prescription of more effective empirical therapies.

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Human liver‐expressed antimicrobial peptide 2 elevation in the cerebrospinal fluid in bacterial meningitis

Brain and Behavior ◽

10.1002/brb3.2111 ◽

2021 ◽

Author(s):

Katsuya Sakai ◽

Kazutaka Shiomi ◽

Hitoshi Mochizuki ◽

Md Nurul Islam ◽

Hiroki Nabekura ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Antimicrobial Peptide ◽

Human Liver

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1554. Epidemiology of Adult Bacterial Hand Infections at Two Urban Hospitals

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1734 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S777-S778

Author(s):

Arsheena Yassin ◽

Christine Stavropoulos ◽

Krystina L Woods ◽

Jiashan Xu ◽

Justin Carale ◽

...

Keyword(s):

New York ◽

Staphylococcus Aureus ◽

Antibiotic Regimen ◽

Gram Positive ◽

Gram Negative ◽

Streptococcus Species ◽

Urban Hospitals ◽

Haemophilus Parainfluenzae ◽

Empiric Antibiotic ◽

Gram Negative Organisms

Abstract Background Hand infections represent a major source of morbidity, which can result in hand stiffness and amputation. Early appropriate empiric antibiotic regimen may reduce the associated morbidity, hence the importance to examine local epidemiology. The aim of this study was to define the current epidemiology of adult hand infections at two urban hospitals in New York City. Methods We performed a double center, retrospective study of adult patients hospitalized from March 2018 to May 2020. Patients with positive cultures associated with the hand infections were included. Retrospectively, 100 patients were reviewed. Data on baseline demographic, clinical, surgical, microbiology, and treatment parameters were collected. Results Of the 100 patients, 76% were male, with median age of 47.5 years (35, 58.25) and average C-reactive protein (CRP) of 50.66 mg/L (± 64.64) on admission (see Table 1). Previous hospitalization within 1 year (38%), previous surgical procedures (39%) and recent IV medication use (26%) were common. 130 bacterial isolates were identified (see Table 2). The most frequent organisms were Gram-positive, with Methicillin susceptible Staphylococcus aureus (MSSA, 25.38%), Streptococcus species (20.08%), and Methicillin resistant Staphylococcus aureus (MRSA, 15.38%) being the most common. Gram-negative organisms were infrequent, with Haemophilus parainfluenzae (3.85%), Enterobacter cloacae (3.85) and Pseudomonas aeruginosa (3.08%) being the most prevalent. Of the 100 patients, 27% had polymicrobial infections, associated with trauma (6%), illicit IV use (6%) and unknown (7%) etiologies. Table 1: Baseline demographics and co-morbid conditions Table 2: Types and numbers of organisms in relation to etiologies Conclusion Within our population, the most common organisms associated with hand infections were Gram-positive, with Staphylococcus aureus and Streptococcus species being the most prevalent. Gram-negative pathogens were infrequently isolated. The results within this study can provide guidance to clinicians on assessing the appropriate empiric antibiotic regimen in patients with hand infections, and can serve as a basis for further studies identifying risk factors associated with isolation of organisms associated with hand infections. Disclosures All Authors: No reported disclosures

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