Streptococcus suis-Associated Meningitis, Bali, Indonesia, 2014-2017
Abstract:
Streptococcus suis is an emerging agent of zoonotic bacterial meningitis in Asia. We describe the epidemiology of S. suis cases and clinical signs and microbiological findings in persons with meningitis in Bali, Indonesia, using patient data and bacterial cultures of cerebrospinal fluid collected during 2014-2017. We conducted microbiological assays using the fully automatic VITEK 2 COMPACT system. We amplified and sequenced gene fragments of glutamate dehydrogenase and recombination/repair protein and conducted PCR serotyping to confirm some serotypes. Of 71 cases, 44 were confirmed as S. suis; 29 isolates were serotype 2. The average patient age was 48.1 years, and 89% of patients were male. Seventy-seven percent of patients with confirmed cases recovered without complications; 11% recovered with septic shock, 7% with deafness, and 2% with deafness and arthritis. The case-fatality rate was 11%. Awareness of S. suis infection risk must be increased in health promotion activities in Bali.
Insights
Bacterial meningitis caused by Streptococcus suis is a growing concern in Asia. In Bali, Indonesia, this emerging zoonotic pathogen caused 44 meningitis cases between 2014-2017, with serotype 2 being most common.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Streptococcus suis is an emerging zoonotic pathogen causing bacterial meningitis, particularly in Asia.
- Understanding the epidemiology and clinical presentation of S. suis meningitis is crucial for public health interventions.
Observation:
- A study in Bali, Indonesia, analyzed 71 meningitis cases from 2014-2017.
- Microbiological assays, including VITEK 2 COMPACT, gene sequencing, and PCR serotyping, were used for diagnosis.
Findings:
- Of 71 cases, 44 were confirmed as Streptococcus suis meningitis.
- Serotype 2 was the predominant isolate (29 cases).
- The average patient age was 48.1 years, with 89% being male. Case-fatality rate was 11%, with complications including septic shock, deafness, and arthritis.
Implications:
- Findings highlight the significant burden of Streptococcus suis meningitis in Bali.
- Increased awareness and health promotion are necessary to mitigate the risk of S. suis infection.
