Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with m...Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.展开更多
Objective Pseudomonas aeruginosa(P.aeruginosa)is a prevalent pathogenic bacterium involved in meningitis;however,the virulence factors contributing to this disease remain poorly understood.Methods The virulence of the...Objective Pseudomonas aeruginosa(P.aeruginosa)is a prevalent pathogenic bacterium involved in meningitis;however,the virulence factors contributing to this disease remain poorly understood.Methods The virulence of the P.aeruginosa A584,isolated from meningitis samples,was evaluated by constructing in vitro blood-brain barrier and in vivo systemic infection models.qPCR,whole-genome sequencing,and drug efflux assays of A584 were performed to analyze the virulence factors.Results Genomic sequencing showed that A584 formed a phylogenetic cluster with the reference strains NY7610,DDRC3,Pa58,and Pa124.Its genome includes abundant virulence factors,such as hemolysin,the Type IV secretion system,and pyoverdine.A584 is a multidrug-resistant strain,and its wide-spectrum resistance is associated with enhanced drug efflux.Moreover,this strain caused significantly more severe damage to the blood-brain barrier than the standard strain,PAO1.qPCR assays further revealed the downregulation of the blood-brain barrier-associated proteins Claudin-5 and Occludin by A584.During systemic infection,A584 exhibited a higher capacity of brain colonization than PAO1(37.1×10^(6) CFU/g brain versus 2.5×10^(6) CFU/g brain),leading to higher levels of the proinflammatory factors IL-1βand TNF-α.Conclusion This study sheds light on the virulence factors of P.aeruginosa involved in meningitis.展开更多
目的:为临床制定李斯特菌抗感染方案的患者提供依据,积累临床合理用药实践经验。方法:对2024年大理大学第一附属医院的一例李斯特菌感染患者病例进行临床资料、疾病特点和抗感染方案制定及分析。结果:治疗后患者病情得以控制,抗感染有...目的:为临床制定李斯特菌抗感染方案的患者提供依据,积累临床合理用药实践经验。方法:对2024年大理大学第一附属医院的一例李斯特菌感染患者病例进行临床资料、疾病特点和抗感染方案制定及分析。结果:治疗后患者病情得以控制,抗感染有效且未出现明显不良反应。结论:李斯特菌脑膜脑炎少见且患者临床表现缺乏特异性,死亡率风险高,抗感染疗程长,临床药师参与制定个体化合理用药方案,保证药物治疗有效性及安全性方面发挥积极重要的作用。Objective: To provide evidence for the clinical management of Listeria infections and to accumulate clinical experience regarding rational drug use. Methods: A case of Listeria infection treated at the First Affiliated Hospital of Dali University in 2024 was analyzed in terms of clinical data, disease characteristics, and antibiotic therapy. Results: The patient’s condition was successfully controlled after treatment, and the antibiotic therapy proved effective without obvious adverse reactions. Conclusion: Listeria meningoencephalitis is rare, and its clinical manifestations lack specificity, with a high risk of mortality. The antibiotic treatment course is prolonged, and the clinical pharmacist plays an active and important role in developing individualized and rational drug treatment plans to ensure the effectiveness and safety of drug therapy.展开更多
目的 分析北京市2006年将A群C群流脑多糖疫苗(Group A and C meningococcal polysaccharide vaccine,MPSV-AC)疫苗纳入免疫规划前后北京市流行性脑脊髓膜炎(流脑)流行特征及脑膜炎球菌(Neisseria meningitidis,Nm)血清群变迁变化趋势,...目的 分析北京市2006年将A群C群流脑多糖疫苗(Group A and C meningococcal polysaccharide vaccine,MPSV-AC)疫苗纳入免疫规划前后北京市流行性脑脊髓膜炎(流脑)流行特征及脑膜炎球菌(Neisseria meningitidis,Nm)血清群变迁变化趋势,评价加强免疫接种程序(第1剂3岁、第2剂9岁)疫苗控制疾病效果,为优化疫苗免疫策略提供科学依据。方法 收集2000-2022年北京市流脑报告病例、2014-2020年国家监测点健康人群Nm带菌率调查数据,分析发病时间趋势、年龄分布特征及Nm血清群变迁情况。结果 将MPSV-AC纳入免疫规划后,发病率由2004年的1.49/10万下降至2007年的0.21/10万,2008-2010年由0.13/10万下降至0.06/10万,2011年以后为0~0.03/10万。MPSV-AC纳入免疫规划前6年高发年龄人群为1、0和15~<20岁年龄组,年均发病率分别为5.08/10万、2.78/10万和1.66/10万。纳入免疫规划后5年全年龄组发病率显著下降,0、1~<6和6~<10岁年龄组较2000-2005年分别下降41.95%、 87.20%和79.98%, 10~<20、≥20岁年龄组下降幅度较1~<10岁人群略低,为76.10%、74.01%, 2011-2022年各年龄组发病率持续维持在低水平,年均发病率较2000-2005年下降幅度在95%以上。病原监测结果阳性40例,以C群、A群、B群和不可分群为主,分别为12例(30.00%)、11例(27.50%)、6例(15.00%)和6例(15.00%),2011年以来无A群报告,W群占比相对上升。2014-2020年健康人群总带菌率为2.29%(328/14 319),各年带菌率为0.68%~3.32%,维持在较低水平;不可分群、B群和W群分别为256例(78.05%)、 53例(16.16%)和9例(2.74%);2014年之后无C群检出,2015年后无A群检出。结论 北京市MPSV-AC疫苗加强免疫接种程序显著降低了<20岁人群全年龄组发病率;优势流行Nm血清群呈现由A群和C群向B群和W群转变趋势,应继续加强流脑监测,必要时考虑是否将MPSV-AC加强剂次调整为含W群成分疫苗。展开更多
文摘Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.
基金supported by National Natural Science Foundation of China,China(32170102)Natural Science Foundation of Tianjin(21JCYBJC01420)the Fundamental Research Funds for the Central Universities(63233050)。
文摘Objective Pseudomonas aeruginosa(P.aeruginosa)is a prevalent pathogenic bacterium involved in meningitis;however,the virulence factors contributing to this disease remain poorly understood.Methods The virulence of the P.aeruginosa A584,isolated from meningitis samples,was evaluated by constructing in vitro blood-brain barrier and in vivo systemic infection models.qPCR,whole-genome sequencing,and drug efflux assays of A584 were performed to analyze the virulence factors.Results Genomic sequencing showed that A584 formed a phylogenetic cluster with the reference strains NY7610,DDRC3,Pa58,and Pa124.Its genome includes abundant virulence factors,such as hemolysin,the Type IV secretion system,and pyoverdine.A584 is a multidrug-resistant strain,and its wide-spectrum resistance is associated with enhanced drug efflux.Moreover,this strain caused significantly more severe damage to the blood-brain barrier than the standard strain,PAO1.qPCR assays further revealed the downregulation of the blood-brain barrier-associated proteins Claudin-5 and Occludin by A584.During systemic infection,A584 exhibited a higher capacity of brain colonization than PAO1(37.1×10^(6) CFU/g brain versus 2.5×10^(6) CFU/g brain),leading to higher levels of the proinflammatory factors IL-1βand TNF-α.Conclusion This study sheds light on the virulence factors of P.aeruginosa involved in meningitis.
文摘目的:为临床制定李斯特菌抗感染方案的患者提供依据,积累临床合理用药实践经验。方法:对2024年大理大学第一附属医院的一例李斯特菌感染患者病例进行临床资料、疾病特点和抗感染方案制定及分析。结果:治疗后患者病情得以控制,抗感染有效且未出现明显不良反应。结论:李斯特菌脑膜脑炎少见且患者临床表现缺乏特异性,死亡率风险高,抗感染疗程长,临床药师参与制定个体化合理用药方案,保证药物治疗有效性及安全性方面发挥积极重要的作用。Objective: To provide evidence for the clinical management of Listeria infections and to accumulate clinical experience regarding rational drug use. Methods: A case of Listeria infection treated at the First Affiliated Hospital of Dali University in 2024 was analyzed in terms of clinical data, disease characteristics, and antibiotic therapy. Results: The patient’s condition was successfully controlled after treatment, and the antibiotic therapy proved effective without obvious adverse reactions. Conclusion: Listeria meningoencephalitis is rare, and its clinical manifestations lack specificity, with a high risk of mortality. The antibiotic treatment course is prolonged, and the clinical pharmacist plays an active and important role in developing individualized and rational drug treatment plans to ensure the effectiveness and safety of drug therapy.
