van de Beek D , Brouwer M , Hasbun R , Koedel U , Whitney CG , Wijdicks E , 2016. Community-acquired bacterial meningitis. Nat Rev Dis Primers 2: 16074.
van Samkar A , Brouwer MC , Schultsz C , van der Ende A , van de Beek D , 2015. Streptococcus suis meningitis: a systematic review and meta-analysis. PLoS Negl Trop Dis 9: e0004191.
Wertheim HF , Nghia HD , Taylor W , Schultsz C , 2009. Streptococcus suis: an emerging human pathogen. Clin Infect Dis 48: 617–625.
Zalas-Wiecek P , Michalska A , Grabczewska E , Olczak A , Pawlowska M , Gospodarek E , 2013. Human meningitis caused by Streptococcus suis. J Med Microbiol 62: 483–485.
Ngo TH et al., 2011. Slaughterhouse pigs are a major reservoir of Streptococcus suis serotype 2 capable of causing human infection in southern Vietnam. PLoS One 6: e17943.
Yu H et al., 2006. Streptococcus suis study groups. Human Streptococcus suis outbreak, Sichuan, China. Emerg Infect Dis 12: 914–920.
Nghia HD et al., 2011. Risk factors of Streptococcus suis infection in Vietnam. A case-control study. PLoS One 6: e17604. Erratum in: PLoS One 2011;6(4); 2012;7(5).
Takeuchi D et al., 2017. Impact of food safety campaign on Streptococcus suis infection in humans in Thailand. Am J Trop Med Hyg 96: 1370–1377.
Navacharoen N , Chantharochavong V , Hanprasertpong C , Kangsanarak J , Lekagul S , 2009. Hearing and vestibular loss in Streptococcus suis infection from swine and traditional raw pork exposure in northern Thailand. J Laryngol Otol 123: 857–862.
Takeuchi D et al., 2012. Population-based study of Streptococcus suis infection in humans in Phayao Province in northern Thailand. PLoS One 7: e31265.
Teekakirikul P , Wiwanitkit V , 2003. Streptococcus suis infection: overview of case reports in Thailand. Southeast Asian J Trop Med Public Health 34 (Suppl 2): 178–183.
Huong VT et al., 2014. Epidemiology, clinical manifestations, and outcomes of Streptococcus suis infection in humans. Emerg Infect Dis 20: 1105–1114.
Fillo S et al., 2018. Draft genome sequence of Streptococcus suis strain SsRC-1, a human isolate from a fatal case of toxic shock syndrome. Genome Announc 6: e00447–e18.
Heidt MC , Mohamed W , Hain T , Vogt PR , Chakraborty T , Domann E , 2005. Human infective endocarditis caused by Streptococcus suis serotype 2. J Clin Microbiol 43: 4898–4901.
Scarborough M , Thwaites GE , 2008. The diagnosis and management of acute bacterial meningitis in resource-poor settings. Lancet Neurol 7: 637–648.
Hasman H , Saputra D , Sicheritz-Ponten T , Lund O , Svendsen CA , Frimodt Moller N , Aarestrup FM , 2014. Rapid whole-genome sequencing for detection and characterization of microorganisms directly from clinical samples. J Clin Microbiol 52: 139e46.
Imai A et al., 2014. Comprehensive metagenomic approach for detecting causative microorganisms in culture-negative infective endocarditis. Int J Cardiol 172: e288e9.
Naccache SN et al., 2014. A cloud-compatible bioinformatics pipeline for ultrarapid pathogen identification from next-generation sequencing of clinical samples. Genome Res 24: 1180e92.
Long SW , Williams D , Valson C , Cantu CC , Cernoch P , Musser JM , Olsen RJ , 2013. A genomic day in the life of a clinical microbiology laboratory. J Clin Microbiol 51: 1272e7.
van de Beek D , de Gans J , Spanjaard L , Weisfelt M , Reitsma JB , Vermeulen M , 2004. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351: 1849–1859.
Dejace J , Bagley P , Wood E , 2017. Streptococcus suis meningitis can require a prolonged treatment course. Int J Infect Dis 65: 34–36.
Rusmeechan S , Sribusara P , 2008. Streptococcus suis meningitis: the newest serious infectious disease. J Med Assoc Thai 91: 654–658.
Kay R , Cheng AF , Tse CY , 1995. Streptococcus suis infection in Hong Kong. QJM 88: 39–47.
Tan JH , Yeh BI , Seet CS , 2010. Deafness due to haemorrhagic labyrinthitis and a review of relapses in Streptococcus suis meningitis. Singapore Med J 51: e30–e33.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||42||42||33|
We analyzed the clinical characteristics and outcomes of patients with Streptococcus suis meningitis in Liuzhou, China, to improve diagnostic accuracy and lower the chances of misdiagnosis. The major clinical manifestations, auxiliary examination results, treatment strategies, treatment efficacy, and follow-up results of 17 consecutively admitted patients with S. suis meningitis were evaluated. The most common clinical manifestations were fever (15/17), sensorineural hearing loss (13/17), headache (11/17), and altered mental status (8/17). In addition, 64.71% of the patients had residual symptoms of sensorineural hearing loss at discharge, and moderate disabilities occurred in 68.75% of the patients in the form of sensorineural deafness (11/17) and hemiparesis (1/17). The cerebrospinal fluid (CSF) of nine patients was used for metagenomic analysis with next-generation sequencing. The metagenomic analysis of CSF of four patients was positive, whereas blood and CSF cultures were negative. The average modified Rankin Scale (mRS) and Activities of Daily Living (ADL) scores improved significantly at the 6-month follow-up compared with those at admission (P < 0.05). There was no correlation between altered mRS and ADL scores and the CSF findings (P > 0.05). Early administration of antibiotics can prevent sensorineural hearing loss. Early CSF metagenomic analysis may be superior to blood and CSF culture.
These authors contributed equally to this work.
Financial support: This work was supported by Guangxi Zhuang Autonomous Region Health and Family Planning Commission Projects (Z2016197, Z20170891, Z20180471, Z20180477, Z20200017, Z20210561, Z20210903, Z20170189) and Liuzhou Science and Technology Plan Projects (2021CBC0121, 2021CBC0128).
Authors’ addresses: Shan Deng, Baoquan Lin, Baohui Weng, Hong Yang, Kejian Zhou, Liya Wu, Lu Qin, and Liya Pan, Department of Neurology, The Fourth Affiliated Hospital of Guangxi Medical University/Liuzhou Workers’ Hospital, Liuzhou, China, E-mails: firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com.