Genomic pneumococcal load and CSF cytokines are not related to outcome in Malawian adults with meningitis

Emma C. Wall; Jenna F. Gritzfeld; Matthew Scarborough; Katherine M.B. Ajdukiewicz; Mavuto Mukaka; Caroline Corless; David Lalloo; Stephen Gordon

doi:10.1016/j.jinf.2014.06.011

Genomic pneumococcal load and CSF cytokines are not related to outcome in Malawian adults with meningitis

Emma C. Wall, Jenna F. Gritzfeld, Matthew Scarborough, Katherine M.B. Ajdukiewicz, Mavuto Mukaka, Caroline Corless, David Lalloo, Stephen Gordon

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Objective

Bacterial meningitis in sub-Saharan Africa is predominantly caused by Streptococcus pneumoniae, is often associated with HIV co-infection and mortality rates are double those seen in better resourced settings.

Methods

To investigate the cause of this excessive mortality we quantified the pneumococcal DNA load and six common pro-inflammatory cytokines in the cerebrospinal fluid (CSF) of Malawian adults with culture proven pneumococcal meningitis and correlated the results to clinical parameters and outcome. There are currently no published data relating bacterial load to outcome in adults with pneumococcal meningitis.

Results

The mean age of patients was 32 years, 82% were HIV infected and 49% had died by day 40. CSF bacterial loads were high (median 6.5 × 105 copies/ml CSF) and there was no significant variation in bacterial load between survivors and non-survivors. All pro-inflammatory CSF cytokines were elevated in the CSF, with no clinically important differences between survivors and non-survivors. HIV status did not affect the CSF bacterial load or cytokine response.

Conclusion

Mortality from pneumococcal meningitis in adults in sub-Saharan Africa is not related to pneumococcal bacterial load. More research is needed to understand the very high mortality from meningitis in this region.

Original language	English
Pages (from-to)	440-446
Number of pages	7
Journal	Journal of Infection
Volume	69
Issue number	5
DOIs	https://doi.org/10.1016/j.jinf.2014.06.011
Publication status	Published - 1 Nov 2014

Keywords

Africa
Bacterial load
Bacterial meningitis
Cerebrospinal fluid
Cytokine response
Mortality
Streptococcus pneumoniae

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jinf.2014.06.011Licence: CC BY

J Infec 69 5 440-446Final published version, 542 KBLicence: CC BY

Cite this

@article{f02d1b3ff33a4f5b8019d37dd16035e7,

title = "Genomic pneumococcal load and CSF cytokines are not related to outcome in Malawian adults with meningitis",

abstract = "ObjectiveBacterial meningitis in sub-Saharan Africa is predominantly caused by Streptococcus pneumoniae, is often associated with HIV co-infection and mortality rates are double those seen in better resourced settings.MethodsTo investigate the cause of this excessive mortality we quantified the pneumococcal DNA load and six common pro-inflammatory cytokines in the cerebrospinal fluid (CSF) of Malawian adults with culture proven pneumococcal meningitis and correlated the results to clinical parameters and outcome. There are currently no published data relating bacterial load to outcome in adults with pneumococcal meningitis.ResultsThe mean age of patients was 32 years, 82\% were HIV infected and 49\% had died by day 40. CSF bacterial loads were high (median 6.5 × 105 copies/ml CSF) and there was no significant variation in bacterial load between survivors and non-survivors. All pro-inflammatory CSF cytokines were elevated in the CSF, with no clinically important differences between survivors and non-survivors. HIV status did not affect the CSF bacterial load or cytokine response.ConclusionMortality from pneumococcal meningitis in adults in sub-Saharan Africa is not related to pneumococcal bacterial load. More research is needed to understand the very high mortality from meningitis in this region.",

keywords = "Africa, Bacterial load, Bacterial meningitis, Cerebrospinal fluid, Cytokine response, Mortality, Streptococcus pneumoniae",

author = "Wall, \{Emma C.\} and Gritzfeld, \{Jenna F.\} and Matthew Scarborough and Ajdukiewicz, \{Katherine M.B.\} and Mavuto Mukaka and Caroline Corless and David Lalloo and Stephen Gordon",

year = "2014",

month = nov,

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doi = "10.1016/j.jinf.2014.06.011",

language = "English",

volume = "69",

pages = "440--446",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "W.B. Saunders Ltd",

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TY - JOUR

T1 - Genomic pneumococcal load and CSF cytokines are not related to outcome in Malawian adults with meningitis

AU - Wall, Emma C.

AU - Gritzfeld, Jenna F.

AU - Scarborough, Matthew

AU - Ajdukiewicz, Katherine M.B.

AU - Mukaka, Mavuto

AU - Corless, Caroline

AU - Lalloo, David

AU - Gordon, Stephen

PY - 2014/11/1

Y1 - 2014/11/1

N2 - ObjectiveBacterial meningitis in sub-Saharan Africa is predominantly caused by Streptococcus pneumoniae, is often associated with HIV co-infection and mortality rates are double those seen in better resourced settings.MethodsTo investigate the cause of this excessive mortality we quantified the pneumococcal DNA load and six common pro-inflammatory cytokines in the cerebrospinal fluid (CSF) of Malawian adults with culture proven pneumococcal meningitis and correlated the results to clinical parameters and outcome. There are currently no published data relating bacterial load to outcome in adults with pneumococcal meningitis.ResultsThe mean age of patients was 32 years, 82% were HIV infected and 49% had died by day 40. CSF bacterial loads were high (median 6.5 × 105 copies/ml CSF) and there was no significant variation in bacterial load between survivors and non-survivors. All pro-inflammatory CSF cytokines were elevated in the CSF, with no clinically important differences between survivors and non-survivors. HIV status did not affect the CSF bacterial load or cytokine response.ConclusionMortality from pneumococcal meningitis in adults in sub-Saharan Africa is not related to pneumococcal bacterial load. More research is needed to understand the very high mortality from meningitis in this region.

AB - ObjectiveBacterial meningitis in sub-Saharan Africa is predominantly caused by Streptococcus pneumoniae, is often associated with HIV co-infection and mortality rates are double those seen in better resourced settings.MethodsTo investigate the cause of this excessive mortality we quantified the pneumococcal DNA load and six common pro-inflammatory cytokines in the cerebrospinal fluid (CSF) of Malawian adults with culture proven pneumococcal meningitis and correlated the results to clinical parameters and outcome. There are currently no published data relating bacterial load to outcome in adults with pneumococcal meningitis.ResultsThe mean age of patients was 32 years, 82% were HIV infected and 49% had died by day 40. CSF bacterial loads were high (median 6.5 × 105 copies/ml CSF) and there was no significant variation in bacterial load between survivors and non-survivors. All pro-inflammatory CSF cytokines were elevated in the CSF, with no clinically important differences between survivors and non-survivors. HIV status did not affect the CSF bacterial load or cytokine response.ConclusionMortality from pneumococcal meningitis in adults in sub-Saharan Africa is not related to pneumococcal bacterial load. More research is needed to understand the very high mortality from meningitis in this region.

KW - Africa

KW - Bacterial load

KW - Bacterial meningitis

KW - Cerebrospinal fluid

KW - Cytokine response

KW - Mortality

KW - Streptococcus pneumoniae

U2 - 10.1016/j.jinf.2014.06.011

DO - 10.1016/j.jinf.2014.06.011

M3 - Article

SN - 0163-4453

VL - 69

SP - 440

EP - 446

JO - Journal of Infection

JF - Journal of Infection

IS - 5

ER -

Genomic pneumococcal load and CSF cytokines are not related to outcome in Malawian adults with meningitis

Abstract

Keywords

UN SDGs

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