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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The current incidence of neonatal sepsis in the United States varies from less than 1 to 8.1 per 1000 live births. The incidence of bacterial meningitis is about one-third of the number of infants with sepsis. The mortality is 20 to 30% and many survivors are severely impaired. Group B streptococcus and Escherichia coli are the most frequent causes of meningitis. Because of the difficulty of clinical diagnosis, many infants receive presumptive therapy for suspected sepsis or meningitis although few have documented infection. Between 5 and 10% of newborn infants born in the United States receive antimicrobial agents in the nursery, usually a penicillin and an aminoglycoside. To lower the continued high mortality and morbidity of meningitis due to gram-negative enteric bacilli, collaborative randomized trials evaluated the efficacy of gentamicin administered via the intrathecal route, gentamicin administered into the ventricle and most recently, the efficacy of moxalactam. Neither intrathecal or intraventricular drug, both in combination with parenteral drug, was advantageous when compared with parenterally administered drug alone. The mortality rate and number of days of culture positive cerebrospinal fluid were similar in infants who received moxalactam and ampicillin and infants who received amikacin and ampicillin. Adjunctive therapies including granulocyte transfusion, administration of hyperimmune gamma globulin and exchange transfusion are now under investigation. Initial studies of prevention of systemic bacterial infection by prophylactic ampicillin administered to the mother at delivery and use of group B streptococcal vaccine administered to susceptible women in the child bearing age show promise.
Infection 1984
PMID:Recent advances in management of bacterial meningitis in neonates. 639 49

Bacterial meningitis of infants and children exact a major toll worldwide. Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis continue to be the major causes, and efforts to reduce the incidence of this disease have had limited success. Major advances in rapid diagnosis, such as antigen detection, have occurred over the past several decades; however, Gram stain, cytologic examination and culture of the CSF remain the most reliable means of making an etiologic diagnosis. Despite shifts in bacterial susceptibilities to commonly used antibacterial agents, penicillin, ampicillin and chloramphenicol remain effective therapy for the vast majority of cases, although newer cephalosporin derivatives may be required to avoid the toxicities of chloramphenicol and to effectively treat selected bacteria that have developed resistance to these more classical antibiotics. The prognosis for bacterial meningitis in infants and children remains guarded because of late diagnosis and the severity of the disease. Major reductions in the incidence of the disease will depend on definition of high-risk populations and application of appropriate preventions.
Infection 1984
PMID:Bacterial meningitis in infants and children. 639 50

Rabbits models of bacterial meningitis have contributed substantially to our understanding of the disease, although the technical characteristics of these models only allow the study of specific aspects of the disease. Bacterial multiplication in the subarachnoidal space is not substantially influenced by host defense mechanisms, mainly because of the lack of sufficient amounts of specific antibodies and functional complement in infected CSF. The multiplying bacteria induce profound changes in the blood-brain barrier, an influx of serum proteins into the CSF and the invasion of polymorphonuclear leukocytes at the site of the infection. The presence of polymorphonuclear leukocytes in CSF not only appears to be of limited value in combating the infection, but also seems to produce deleterious effects on the central nervous system. Components of the leukocytes, such as unsaturated fatty acids, arachidonic metabolites and free oxygen radicals, may contribute to the profound hydrodynamic, structural and metabolic changes that are currently under study in experimental models of the disease. A better understanding of the pathophysiology of bacterial meningitis may allow us to design more effective therapeutic strategies and improve the outcome of this disease.
Infection 1984
PMID:Pathogenesis of bacterial meningitis: contributions by experimental models in rabbits. 639 52

Three species of bacteria (Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumoniae) cause approximately three-quarters of all cases of acute bacterial meningitis in industrialized and developing countries. Infections due to N. meningitidis, S. pneumoniae, and H. influenzae type b are endemic in most countries; major epidemics of meningococcal disease still occur regularly, especially in sub- Saharan Africa. Such epidemics may be large, involving many thousands of patients, with a mortality that can exceed 10%. Both chemoprophylaxis and immunization are used to prevent meningococcal, pneumococcal, and H. influenzae type b meningitis. Chemoprophylaxis may involve the use of expensive antibiotics, and it can encourage the emergence of drug resistance. Mass immunization with meningococcal polysaccharide vaccine can effectively halt an epidemic of group A or group C meningococcal disease, and immunization protects close contacts. However, polysaccharide vaccines are ineffective in infants, who are very susceptible to bacterial meningitis. New protein-polysaccharide conjugated vaccines may be more effective in this young population.
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PMID:Selective primary health care: strategies for control of disease in the developing world. XIII. Acute bacterial meningitis. 642 12

The concentrations of mezlocillin in the cerebrospinal fluid were measured in ten patients with viral meningitis after a single infusion of 5 g lasting 30 minutes. One to two hours after infusion the CSF concentrations were between 0.1 mcg/ml and 1.6 mcg/ml, and thus exceeded the minimal inhibitory concentrations of Neisseria meningitidis and Diplococcus pneumoniae, the most common pathogens in bacterial meningitis in adults. The minimal inhibitory concentration of ampicillin-sensitive strains of Haemophilus influenzae was also attained. Further investigations must be carried out, in order to ascertain whether higher CSF concentrations are attained in bacterial meningitis.
Infection 1980
PMID:[Concentrations of mezlocillin in cerebrospinal fluid in vira meningitis (author's transl)]. 645 3

White blood cell count (WBC), erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) were determined upon diagnosis of 61 children with bacterial meningitis in order to compare the responses evoked by different bacteria. The age of the patients and the duration of their symptoms were similar in all groups. WBC and ESR corresponded significantly with the bacterial species. The mean WBC in Haemophilus influenzae (n = 44), meningococcal (n = 11) and pneumococcal (n = 6) infection were 14,605/microliters 19,391/microliters and 23,833/microliters, respectively (for H. influenzae and pneumococci p less than 0.001). The mean ESR varied from 58 mm/h (meningococci) to 100 mm/h (pneumococci) (p less than 0.025). CRP was the test least influenced by the nature of the bacteria. The characteristics of CRP suggest its superiority over WBC and ESR as a detector of bacteremic infections. WBC is unsuitable for screening of systemic H. influenzae disease.
Infection
PMID:White blood cell count, erythrocyte sedimentation rate and serum C-reactive protein in meningitis: magnitude of the response related to bacterial species. 651 Oct 86

The minimum inhibitory concentrations (MIC) of penicillin G, ampicillin, mezlocillin, azlocillin, cephalothin and cefoxitin were determined for 47 strains of Haemophilus influenzae, 68 strains of Neisseria meningitidis and 45 strains of Streptococcus pneumoniae. These strains were isolated during the past three years from patients with acute bacterial meningitis. Three strains of H. influenzae were ampicillin-resistant while no pneumococcus or meningococcus strain was penicillin-resistant. Mezlocillin was the most potent antibiotic against the Haemophilus and pneumococcus strains, followed closely by azlocillin. Mezlocillin inhibited 77.7% of the meningococci strains tested at a concentration of 0.03 mg/l. Penicillin G was the most effective of the drugs against these strains. It inhibited 100% at a concentration of 0.5 mg/l. The cephalosporins were the least active of the six beta-lactam antibiotics tested.
Infection 1982
PMID:Comparative activity of six beta-lactam antibiotics against strains of Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. 681 56

The lactate, lysozyme, C-reactive protein and serum amyloid-A protein concentrations in cerebrospinal fluid were measured in 11 patients with bacterial meningitis, 27 patients with aseptic meningitis and in 31 control patients. The mean concentration of each parameter was significantly higher (p less than or equal to 0.0001) in patients with bacterial meningitis than in those with aseptic meningitis or those without meningitis. The reliability of these tests in the differential diagnosis of bacterial and aseptic meningitis was compared with leucocyte counts in cerebrospinal fluid. Gram staining for bacteria, and protein and glucose levels. The cerebrospinal fluid lactate level proved to be more sensitive than lysozyme. C-reactive protein or serum amyloid-A protein and had a high degree of specificity.
Infection
PMID:The differential diagnosis of bacterial and aseptic meningitis using cerebrospinal fluid laboratory tests. 688 72

The reaction of cerebrospinal fluid (CSF) granulocytes in the nitroblue-tetrazolium test (NBT test) was evaluated. In a previous study, methodological problems were resolved, and the method developed by Park et al, was modified to suit the special conditions of the CSF. Thirty-eight CSF specimens from 26 patients were analysed. It appears that NBT test results with CSF granulocytes are significantly positive--according to the criteria developed by Park for blood granulocytes--when bacterial meningitis is present. If the cause of the pleocytosis is not bacterial in nature, then the test results are negative in most cases, provided that the CSF sample contains little or no blood. The NBT test in bloody CSF may produce positive results no matter what the cause of the pleocytosis. Our results suggest that the NBT test is a general, non-specific indicator of granulocyte stimulation. It reflects the ability of granulocytes to react to a stress situation of the organism. Bacterial infection results in a conspicuously large number of stimulated (i.e. NBT positive) granulocytes.
Infection 1980
PMID:The Significance of the nitroblue-tetrazolium test in cerebrospinal fluid granulocytes in bacterial and abacterial meningitis. 702 31

Elderly persons are prone to more frequent or greater morbidity and higher mortality from selected infectious diseases than the average population. Factors that may affect this increased predilection or poorer prognosis include environmental exposure, normal physiological changes of aging, coexistence of chronic diseases and alteration of host defense mechanisms. Infections to which the aged are particularly vulnerable are pneumonia, influenza, tuberculosis, urinary tract infection, Gram-negative bacteremia, intra-abdominal sepsis, soft tissue infection, infective endocarditis, bacterial meningitis, bacterial arthritis and herpes zoster infection.
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PMID:Important infections in elderly persons. 703 32


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