Community-Acquired CNS Infections in Western Asia (2010-2025): A Systematic Review

Area of Science:

• Infectious Diseases
• Neurology
• Public Health

Background:

• Central nervous system (CNS) infections are a major global health concern.
• Western Asian countries face unique challenges in managing these infections due to diverse etiologies and limited resources.

Purpose of the Study:

• To systematically review the epidemiology, etiology, diagnostics, antimicrobial resistance, and outcomes of community-acquired CNS infections in Western Asia.
• To identify key challenges and inform strategies for improved management and prevention.

Main Methods:

• A systematic literature search of PubMed was performed for studies from January 2010 to July 2025.
• Included original research and case reports on CNS infections in Western Asia; excluded unrelated studies.
• Data were narratively synthesized, and risk of bias was assessed.

Main Results:

• 450 studies identified common bacterial pathogens like Streptococcus pneumoniae and Neisseria meningitidis, and viral agents including Enteroviruses.
• Notable findings include multidrug-resistant Gram-negative organisms, tuberculous meningitis, neurobrucellosis, and increasing post-COVID-19 autoimmune encephalitis.
• High rates of pneumococcal penicillin resistance (over 40%) were observed, alongside limited molecular diagnostics and surveillance.

Conclusions:

• Community-acquired CNS infections remain a substantial health burden in Western Asia.
• Heterogeneity in studies and data gaps limit comprehensive understanding, particularly regarding antimicrobial resistance.
• Recommendations include expanded vaccination, improved diagnostics, strengthened surveillance, and regional antimicrobial resistance monitoring to reduce mortality and sequelae.