Genomic pneumococcal load and CSF cytokines are not related to outcome in Malawian adults with meningitis

Wall, Emma, Gritzfeld, Jenna, Scarborough, Matthew, Ajdukiewicz, Katherine M.B., Mukaka, Mavuto, Corless, Caroline, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200 and Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116 (2014) 'Genomic pneumococcal load and CSF cytokines are not related to outcome in Malawian adults with meningitis'. Journal of Infection, Vol 69, Issue 5, pp. 440-446.

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Abstract

Objective

Bacterial meningitis in sub-Saharan Africa is predominantly caused by Streptococcus pneumoniae, is often associated with HIV co-infection and mortality rates are double those seen in better resourced settings.

Methods

To investigate the cause of this excessive mortality we quantified the pneumococcal DNA load and six common pro-inflammatory cytokines in the cerebrospinal fluid (CSF) of Malawian adults with culture proven pneumococcal meningitis and correlated the results to clinical parameters and outcome. There are currently no published data relating bacterial load to outcome in adults with pneumococcal meningitis.

Results

The mean age of patients was 32 years, 82% were HIV infected and 49% had died by day 40. CSF bacterial loads were high (median 6.5 × 105 copies/ml CSF) and there was no significant variation in bacterial load between survivors and non-survivors. All pro-inflammatory CSF cytokines were elevated in the CSF, with no clinically important differences between survivors and non-survivors. HIV status did not affect the CSF bacterial load or cytokine response.

Conclusion

Mortality from pneumococcal meningitis in adults in sub-Saharan Africa is not related to pneumococcal bacterial load. More research is needed to understand the very high mortality from meningitis in this region.

Item Type:	Article
Subjects:	QU Biochemistry > Genetics > QU 460 Genomics. Proteomics QW Microbiology and Immunology > Immunity by Type > QW 568 Cellular immunity. Immunologic cytotoxicity. Immunocompetence. Immunologic factors (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 217 Pneumococcal infections WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 245 Meningococcal infections
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.jinf.2014.06.011
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	30 Jan 2015 15:39
Last Modified:	07 Oct 2019 08:24
URI:	https://archive.lstmed.ac.uk/id/eprint/4829

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