The burden and epidemiology of community-acquired central nervous system infections: a multinational study

被引：70

作者：

Erdem, H. ^{[1
,2
]}

Inan, A. ^{[3
]}

Guven, E. ^{[4
]}

Hargreaves, S. ^{[5
]}

Larsen, L. ^{[6
]}

Shehata, G. ^{[7
]}

Pernicova, E. ^{[8
,9
,10
]}

Khan, E. ^{[11
]}

Bastakova, L. ^{[12
,13
]}

Namani, S. ^{[14
]}

Harxhi, A. ^{[15
]}

Roganovic, T. ^{[16
]}

Lakatos, B. ^{[17
]}

Uysal, S. ^{[18
]}

Sipahi, O. R. ^{[19
]}

Crisan, A. ^{[20
]}

Miftode, E. ^{[21
]}

Stebel, R. ^{[12
,13
]}

Jegorovic, B. ^{[22
]}

Feher, Z. ^{[23
]}

Jekkel, C. ^{[17
]}

Pandak, N. ^{[24
]}

Moravveji, A. ^{[25
]}

Yilmaz, H. ^{[26
]}

Khalifa, A. ^{[27
]}

Musabak, U. ^{[28
]}

Yilmaz, S. ^{[29
]}

Jouhar, A. ^{[27
]}

Oztoprak, N. ^{[30
]}

Argemi, X. ^{[31
]}

Baldeyrou, M. ^{[31
]}

Bellaud, G. ^{[32
]}

Moroti, R. V. ^{[33
,34
]}

Hasbun, R. ^{[35
]}

Salazar, L. ^{[35
]}

Tekin, R. ^{[36
]}

Canestri, A. ^{[32
]}

Calkic, L. ^{[37
]}

Pratico, L. ^{[38
]}

Yilmaz-Karadag, F. ^{[39
]}

Santos, L. ^{[40
,41
]}

Pinto, A. ^{[40
,41
]}

Kaptan, F. ^{[42
]}

Bossi, P. ^{[43
]}

Aron, J. ^{[43
]}

Duissenova, A. ^{[44
]}

Shopayeva, G. ^{[44
]}

Utaganov, B. ^{[44
]}

Grgic, S. ^{[45
]}

Ersoz, G. ^{[46
]}

机构：

[1] ID IRI, Ankara, Turkey

[2] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, TR-06010 Ankara, Turkey

[3] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[4] Beytepe Murat Erdi Eker State Hosp, Ankara, Turkey

[5] Imperial Coll London, Int Hlth Unit, Sect Infect Dis & Immun, Commonwealth Bldg,Hammersmith Campus, London, England

[6] Odense Univ Hosp, Dept Infect Dis Q, Odense, Denmark

[7] Assiut Univ Hosp, Dept Neurol & Psychiat, Assiut, Egypt

[8] Avenier, Ctr Vaccinat, Prague, Czech Republic

[9] Avenier, Ctr Travel Med, Prague, Czech Republic

[10] Dept Infect Dis, Fac Hosp Brno, Brno, Czech Republic

[11] Shifa Int Hosp, Islamabad, Pakistan

[12] Dept Infect Dis, Fac Hosp Brno, Brno, Czech Republic

[13] Masaryk Univ, Fac Med, Brno, Czech Republic

[14] Univ Clin Ctr Kosovo, Infect Dis Clin, Prishtina, Kosovo

[15] Univ Hosp Ctr Tirana, Serv Infect Dis, Tirana, Albania

[16] Univ Hosp Clin Ctr Banja Luka, Infect Dis Clin, Banja Luka, Bosnia & Herceg

[17] St Laszlo Hosp, Dept Infect Dis, Budapest, Hungary

[18] Seyfi Demirsoy State Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[19] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[20] Victor Babes Univ Med & Pharm, Dept Infect Dis, Timisoara, Romania

[21] Gr T Popa Univ Med & Pharm, Hosp Infect Dis, Iasi, Romania

[22] Univ Belgrade, Clin Infect & Trop Dis, Clin Ctr Serbia, Fac Med, Belgrade, Serbia

[23] Markusovszky Univ Teaching Hosp, Dept Infect Dis, Szombathely, Hungary

[24] Univ Split, Gen Hosp Slavonski Brod, Dept Infect Dis, Sch Med, Split, Croatia

[25] Kashan Univ Med Sci, Social Determinants Hlth Res Ctr, Dept Community Med, Kashan, Iran

[26] Ondokuz Mayis Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Samsun, Turkey

[27] Damascus Hosp, Dept Neurol, Damascus, Syria

[28] Losante Hosp, Dept Immunol & Allergy, Ankara, Turkey

[29] Gulhane Mil Med Acad, Clin Microbiol Div, Blood Bank, Ankara, Turkey

[30] Antalya Educ & Res Hosp, Antalya, Turkey

[31] Nouvel Hop Civil, Infect Dis Dept, Strasbourg, France

[32] Tenon Univ Hosp, Dept Infect Dis, Paris, France

[33] Carol Davila Univ Med & Pharm, Bucharest, Romania

[34] Matei Bals Natl Inst Infect Dis, Bucharest, Romania

[35] Univ Texas Hlth Sci Ctr Houston, Med Sch, Dept Infect Dis, Houston, TX 77030 USA

[36] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey

[37] Zenica Cantonal Hosp, Dept Infect Dis, Zenica, Bosnia & Herceg

[38] Univ Div Infect & Trop Dis, Piazza Spedali Civili, I-25123 Brescia, Italy

[39] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[40] Univ Porto, Ctr Hosp Sao Joao, Infect Dis Serv, Oporto, Portugal

[41] Univ Porto, Fac Med, Oporto, Portugal

[42] Katip Celebi Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey

[43] Inst Pasteur Paris HPA, Dept Malad Infect, Paris, France

[44] Asfendiyarov Kazakh Natl Med Univ, Dept Infect & Trop Dis, Alma Ata, Kazakhstan

[45] Univ Hosp Mostar, Clin Infect Dis, Mostar, Bosnia & Herceg

[46] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey

[47] Pamela Youde Nethersole Eastern Hosp, Dept Clin Pathol, Hong Kong SAR, Peoples R China

[48] Gen Hosp Dubrovnik, Dept Infect Dis, Dubrovnik, Croatia

[49] Kashan Univ Med Sci, Dept Infect Dis, Social Determinants Hlth Res Ctr, Kashan, Iran

[50] Astana Med Univ, Dept Infect Dis, Astana, Kazakhstan

来源：

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES | 2017年 / 36卷 / 09期

关键词：

ACUTE BACTERIAL-MENINGITIS; CLINICAL CHARACTERISTICS; PRACTICE GUIDELINES; DIAGNOSIS; MANAGEMENT; DISEASE;

D O I：

10.1007/s10096-017-2973-0

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure. The most frequent infecting pathogens in this study were Streptococcus pneumoniae (n = 206, 8%) and Mycobacterium tuberculosis (n = 152, 5.9%). Varicella zoster virus and Listeria were other common pathogens in the elderly. Although staphylococci and Listeria resulted in frequent infections in immunocompromised patients, cryptococci were leading pathogens in human immunodeficiency virus (HIV)-positive individuals. Among the patients with any proven etiology, 96 (8.9%) patients presented with clinical features of a chronic CNS disease. Neurosyphilis, neurobrucellosis, neuroborreliosis, and CNS tuberculosis had a predilection to present chronic courses. Listeria monocytogenes, Staphylococcus aureus, M. tuberculosis, and S. pneumoniae were the most fatal forms, while sequelae were significantly higher for herpes simplex virus type 1 (p < 0.05 for all). Tackling the high burden of CNS infections globally can only be achieved with effective pneumococcal immunization and strategies to eliminate tuberculosis, and more must be done to improve diagnostic capacity.

引用

页码：1595 / 1611

页数：17

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