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Identification of viridans streptococcal species causing bacterial meningitis in adults in Taiwan
1Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan.
Abstract:
In order to determine the species responsible for viridans-group streptococcal meningitis in adults in Taiwan, seven cases of culture-proven meningitis due to these organisms were studied. The cases were all identified at the Chang Gung Memorial Hospital-Kaohsiung over a period of 3 years, and they accounted for 9% (7/78) of all cases of culture-proven bacterial meningitis occurring in adults during this period. Of the seven viridans streptococci isolates recovered, Streptococcus constellatus accounted for four, Streptococcus anginosus for two, and Streptococcus oralis for one. Thus, it appears that streptococci of the milleri group are the most common species causing bacterial meningitis in adults in Taiwan. The tendency for these organisms to cause invasive central nervous system infections in adults should not be overlooked when these species are recovered from cerebrospinal fluid specimens.
Insights
In Taiwan, Streptococcus milleri group bacteria are the primary cause of adult bacterial meningitis. This study identified Streptococcus constellatus as the most frequent species responsible for these invasive central nervous system infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Neurology
Background:
- Viridans-group streptococci are increasingly recognized as opportunistic pathogens.
- Bacterial meningitis remains a significant cause of morbidity and mortality in adults.
- Limited data exists on the specific species causing meningitis in Taiwan.
Purpose of the Study:
- To identify the predominant viridans-group streptococcal species causing meningitis in adults in Taiwan.
- To assess the prevalence of these infections within the overall burden of adult bacterial meningitis.
Main Methods:
- Retrospective analysis of seven culture-proven cases of viridans-group streptococcal meningitis.
- Isolates were identified to the species level.
- Case data collected over a three-year period at a single tertiary care hospital.
Main Results:
- Viridans-group streptococci accounted for 9% (7/78) of adult bacterial meningitis cases.
- Streptococcus constellatus was the most common species (4/7 isolates).
- Streptococcus anginosus (2/7) and Streptococcus oralis (1/7) were also identified.
Conclusions:
- Streptococci of the milleri group are the most common cause of adult bacterial meningitis in Taiwan.
- The potential for these species to cause invasive central nervous system infections should be recognized.
- Clinical vigilance is warranted when these bacteria are isolated from cerebrospinal fluid.