在成年人中出现的社区性肺炎球菌脑膜炎,有或没有确定的易感因子
Maria Cecilia Cergole-Novella1, Elaine Monteiro Matsuda2, Mariana Brena de Souza1
1Adolfo Lutz Institute, Santo André Regional Center, Avenida Ramiro Colleoni, 240 - Vila Dora, Santo André, SP, 09040-160, Brazil.
概括
经常性细菌性脑膜炎,主要是由肺炎菌杆菌引起的,即使没有易感因素,也会影响个体. 分子工具有助于追踪这些罕见但严重的感染,突显了肺炎球菌疫苗接种的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 分子诊断学 分子诊断学
背景情况:
- 细菌性脑膜炎仍然是一个重要的公共卫生问题,患病率和死亡率很高.
- 复发性脑膜炎虽然很少见,但可能是由诱导因素引发的.
- 了解复发性脑膜炎的流行病学对于有效的公共卫生战略至关重要.
研究的目的:
- 为了确定复发性社区获得性脑膜炎的临床特征.
- 分析导致脑膜炎复发的病原体的分子流行病学,有或没有诱导因素.
- 评估分子工具在诊断和监测脑膜炎病原体方面的实用性.
主要方法:
- 从2010年到2020年对实验室数据库的回顾性研究.
- 对脑脊液样本进行分子分析,以识别病原体,特别是在没有孤立菌株的情况下.
- 分析临床数据,包括患者年龄和易感因素.
主要成果:
- 在1779例脑膜炎病例中,七名患者中有16例是复发性 (0.9%),主要是由Streptococcus pneumoniae引起的.
- 复发性脑膜炎患者的平均年龄为20岁;三名患者有预易性因素.
- 确定的肺炎球菌血清型往往不被疫苗覆盖,并且对抗生素敏感.
结论:
- 分子工具对于常规诊断中的流行病学监测是有价值的.
- 肺炎链球菌 (Streptococcus pneumoniae) 是社区性脑膜炎复发的主要原因,即使没有易感因素.
- 对于通常不被认为是高风险的人来说,肺炎球菌疫苗接种可能是合理的.
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