Community-acquired bacterial meningitis.
Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. It can be acquired spontaneously in the community - community-acquired bacterial meningitis - or in the hospital as a complication of invasive procedures or head trauma (nosocomial bacterial meningitis). Despite advances in treatment and vaccinations, community-acquired bacterial meningitis remains one of the most important infectious diseases worldwide. Streptococcus pneumoniae and Neisseria meningitidis are the most common causative bacteria and are associated with high mortality and morbidity; vaccines targeting these organisms, which have designs similar to the successful vaccine that targets Haemophilus influenzae type b meningitis, are now being used in many routine vaccination programmes. Experimental and genetic association studies have increased our knowledge about the pathogenesis of bacterial meningitis. Early antibiotic treatment improves the outcome, but the growing emergence of drug resistance as well as shifts in the distribution of serotypes and groups are fuelling further development of new vaccines and treatment strategies. Corticosteroids were found to be beneficial in high-income countries depending on the bacterial species. Further improvements in the outcome are likely to come from dampening the host inflammatory response and implementing preventive measures, especially the development of new vaccines.
Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. BOX 22660, 1100DD Amsterdam, The Netherlands.
Diederik
D
van de Beek
Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. BOX 22660, 1100DD Amsterdam, The Netherlands.
Matthijs
M
Brouwer
Department of Internal Medicine, UT Health McGovern Medical School, Houston, Texas, USA.
Rodrigo
R
Hasbun
Department of Neurology, Clinic Grosshadern of the Ludwig-Maximilians University of Munich, Munich, Germany.
Uwe
U
Koedel
Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Cynthia G
CG
Whitney
Division of Critical Care Neurology, Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Eelco
E
Wijdicks
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000503:physiopathology*; D006193:Haemophilus influenzae / Q000472:pathogenicity; D006801:Humans; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology*; D009345:Neisseria meningitidis / Q000472:pathogenicity; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000472:pathogenicity
D000900:Anti-Bacterial Agents