title: Threshold shift: effects of cochlear implantation on the risk of pneumococcal meningitis.
abstract: OBJECTIVE
  The study goals were to examine whether cochlear implantation increases the risk of meningitis in the absence of other risk factors and to understand the pathogenesis of pneumococcal meningitis post cochlear implantation.
  
  
  METHODS
  Four weeks following surgery, 54 rats (18 of which received a cochleostomy alone, 18 of which received a cochleostomy and acute cochlear implantation using standard surgical techniques, and 18 of which received a cochlear implant) were infected with Streptococcus pneumoniae via three different routes of bacterial inoculation (middle ear, inner ear, and intraperitoneal) to represent all potential routes of bacterial infection from the upper respiratory tract to the meninges.
  
  
  RESULTS
  The presence of a cochlear implant reduced the threshold of bacteria required to cause pneumococcal meningitis from all routes of infection in healthy animals.
  
  
  CONCLUSIONS
  The presence of a cochlear implant increases the risk of pneumococcal meningitis regardless of the route of bacterial infection.
  
  
  CONCLUSIONS
  Early detection and treatment of pneumococcal infection such as otitis media may be required, as cochlear implantation may lead to a reduction of infectious threshold for meningitis.
authors.affiliation: Bionic Ear Institute, the University of Melbourne, Melbourne, Victoria, Australia. bwei@bionicear.org
authors.forename: Benjamin P C
authors.initials: BP
authors.lastname: Wei
authors.forename: Robert K
authors.initials: RK
authors.lastname: Shepherd
authors.forename: Roy M
authors.initials: RM
authors.lastname: Robins-Browne
authors.forename: Graeme M
authors.initials: GM
authors.lastname: Clark
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: O'Leary
mesh_terms: D000818:Animals; D019929:Cochlear Implantation; D003054:Cochlear Implants / Q000009:adverse effects*; D008586:Meningitis, Pneumococcal / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D051381:Rats; D017208:Rats, Wistar; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000472:pathogenicity