Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.

Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Sh...

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Autores principales: Yekaterina Bumburidi, Gulmira Utepbergenova, Bakhtygali Yerezhepov, Nursulu Berdiyarova, Kaldikul Kulzhanova, Jennifer Head, Daphne Moffett, Daniel Singer, Pawan Angra, Toni Whistler, James Sejvar
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:74b1f45adac84e62a49960b7283ff2c82021-12-02T20:04:02ZEtiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.1932-620310.1371/journal.pone.0251494https://doaj.org/article/74b1f45adac84e62a49960b7283ff2c82021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251494https://doaj.org/toc/1932-6203Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Shymkent City Hospital, in the South Kazakhstan region. All consenting inpatients meeting a standard case definition were enrolled. Blood and cerebrospinal fluid (CSF) samples were collected for bacterial culture, and CSF samples were additionally tested by PCR for four bacterial species and three viruses using a cascading algorithm. We enrolled 556 patients. Of these, 494 were of viral etiology (including 4 probable rabies cases), 37 were of bacterial etiology, 19 were of unknown etiology and 6 were not tested. The most commonly identified pathogens included enterovirus (73%, n = 406 cases), herpes simplex virus (12.8%, n = 71), and Neisseria meningitidis (3.8%, n = 21). The incidence rates (IRs) for enteroviral and meningococcal EM were found to be 14.5 and 0.7 per 100,000 persons, respectively. The IR for bacterial EM using both PCR and culture results was 3-5 times higher compared to culture-only results. Antibacterial medicines were used to treat 97.2% (480/494) of virus-associated EM. Incorporation of PCR into routine laboratory diagnostics of EM improves diagnosis, pathogen identification, ensures IRs are not underestimated, and can help avoid unnecessary antibacterial treatment.Yekaterina BumburidiGulmira UtepbergenovaBakhtygali YerezhepovNursulu BerdiyarovaKaldikul KulzhanovaJennifer HeadDaphne MoffettDaniel SingerPawan AngraToni WhistlerJames SejvarPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251494 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Yekaterina Bumburidi
Gulmira Utepbergenova
Bakhtygali Yerezhepov
Nursulu Berdiyarova
Kaldikul Kulzhanova
Jennifer Head
Daphne Moffett
Daniel Singer
Pawan Angra
Toni Whistler
James Sejvar
Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.
description Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Shymkent City Hospital, in the South Kazakhstan region. All consenting inpatients meeting a standard case definition were enrolled. Blood and cerebrospinal fluid (CSF) samples were collected for bacterial culture, and CSF samples were additionally tested by PCR for four bacterial species and three viruses using a cascading algorithm. We enrolled 556 patients. Of these, 494 were of viral etiology (including 4 probable rabies cases), 37 were of bacterial etiology, 19 were of unknown etiology and 6 were not tested. The most commonly identified pathogens included enterovirus (73%, n = 406 cases), herpes simplex virus (12.8%, n = 71), and Neisseria meningitidis (3.8%, n = 21). The incidence rates (IRs) for enteroviral and meningococcal EM were found to be 14.5 and 0.7 per 100,000 persons, respectively. The IR for bacterial EM using both PCR and culture results was 3-5 times higher compared to culture-only results. Antibacterial medicines were used to treat 97.2% (480/494) of virus-associated EM. Incorporation of PCR into routine laboratory diagnostics of EM improves diagnosis, pathogen identification, ensures IRs are not underestimated, and can help avoid unnecessary antibacterial treatment.
format article
author Yekaterina Bumburidi
Gulmira Utepbergenova
Bakhtygali Yerezhepov
Nursulu Berdiyarova
Kaldikul Kulzhanova
Jennifer Head
Daphne Moffett
Daniel Singer
Pawan Angra
Toni Whistler
James Sejvar
author_facet Yekaterina Bumburidi
Gulmira Utepbergenova
Bakhtygali Yerezhepov
Nursulu Berdiyarova
Kaldikul Kulzhanova
Jennifer Head
Daphne Moffett
Daniel Singer
Pawan Angra
Toni Whistler
James Sejvar
author_sort Yekaterina Bumburidi
title Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.
title_short Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.
title_full Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.
title_fullStr Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.
title_full_unstemmed Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.
title_sort etiology of acute meningitis and encephalitis from hospital-based surveillance in south kazakhstan oblast, february 2017-january 2018.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/74b1f45adac84e62a49960b7283ff2c8
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