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Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis

BACKGROUND: Despite bacteraemia is present in the majority of patients with pneumococcal, little is known about the influence of the systemic infection on the meningeal inflammatory response. METHODS: To explore the role of systemic infection on the meningeal inflammation, experimental meningitis wa...

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Autores principales: ∅stergaard, Christian, O'Reilly, Terence, Brandt, Christian, Frimodt-Møller, Niels, Lundgren, Jens D
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1475592/
https://www.ncbi.nlm.nih.gov/pubmed/16643642
http://dx.doi.org/10.1186/1471-2334-6-78
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author ∅stergaard, Christian
O'Reilly, Terence
Brandt, Christian
Frimodt-Møller, Niels
Lundgren, Jens D
author_facet ∅stergaard, Christian
O'Reilly, Terence
Brandt, Christian
Frimodt-Møller, Niels
Lundgren, Jens D
author_sort ∅stergaard, Christian
collection PubMed
description BACKGROUND: Despite bacteraemia is present in the majority of patients with pneumococcal, little is known about the influence of the systemic infection on the meningeal inflammatory response. METHODS: To explore the role of systemic infection on the meningeal inflammation, experimental meningitis was induced by intracisternal injection of ~1 × 10(6 )CFU Streptococcus pneumoniae, type 3, and the 26 rabbits were either provided with ~1 × 10(6 )CFU S. pneumoniae intravenously at 0 hour ("bacteraemic" rabbits, n = 9), immunized with paraformaldehyde-killed S. pneumoniae for 5 weeks prior to the experiment ("immunized" rabbits", n = 8), or not treated further ("control" rabbits, n = 9). WBC and bacterial concentrations were determined in CSF and blood every second hour during a 16 hours study period together with CSF IL-8 and protein levels. We also studied CSF and blood WBC levels in 153 pneumococcal meningitis patients with and without presence of bacteraemia. RESULTS: As designed, blood bacterial concentrations were significantly different among three experimental groups during the 16 hours study period (Kruskal Wallis test, P < 0.05), whereas no differences in CSF bacterial levels were observed (P > 0.05). Blood WBC decreased in bacteraemic rabbits between ~10–16 hours after the bacterial inoculation in contrast to an increase for both the immunized rabbits and controls (P < 0.05). The CSF pleocytosis was attenuated in bacteraemic rabbits as compared to the two other groups between 12–16 hours from time of infection (P < 0.017), despite accelerated CSF IL-8 levels in bacteraemic rabbits. In patients with pneumococcal meningitis, no significant difference in CSF WBC was observed between patients with or without bacteraemia at admission (n = 103, 1740 cells/μL (123–4032) vs. n = 50, 1961 cells/μL (673–5182), respectively, P = 0.18), but there was a significant correlation between CSF and blood WBC (n = 127, Spearman rho = 0.234, P = 0.008). CONCLUSION: Our results suggest that a decrease in peripheral WBC induced by enhanced bacteraemia in pneumococcal meningitis results in an attenuated CSF pleocytosis.
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spelling pubmed-14755922006-06-08 Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis ∅stergaard, Christian O'Reilly, Terence Brandt, Christian Frimodt-Møller, Niels Lundgren, Jens D BMC Infect Dis Research Article BACKGROUND: Despite bacteraemia is present in the majority of patients with pneumococcal, little is known about the influence of the systemic infection on the meningeal inflammatory response. METHODS: To explore the role of systemic infection on the meningeal inflammation, experimental meningitis was induced by intracisternal injection of ~1 × 10(6 )CFU Streptococcus pneumoniae, type 3, and the 26 rabbits were either provided with ~1 × 10(6 )CFU S. pneumoniae intravenously at 0 hour ("bacteraemic" rabbits, n = 9), immunized with paraformaldehyde-killed S. pneumoniae for 5 weeks prior to the experiment ("immunized" rabbits", n = 8), or not treated further ("control" rabbits, n = 9). WBC and bacterial concentrations were determined in CSF and blood every second hour during a 16 hours study period together with CSF IL-8 and protein levels. We also studied CSF and blood WBC levels in 153 pneumococcal meningitis patients with and without presence of bacteraemia. RESULTS: As designed, blood bacterial concentrations were significantly different among three experimental groups during the 16 hours study period (Kruskal Wallis test, P < 0.05), whereas no differences in CSF bacterial levels were observed (P > 0.05). Blood WBC decreased in bacteraemic rabbits between ~10–16 hours after the bacterial inoculation in contrast to an increase for both the immunized rabbits and controls (P < 0.05). The CSF pleocytosis was attenuated in bacteraemic rabbits as compared to the two other groups between 12–16 hours from time of infection (P < 0.017), despite accelerated CSF IL-8 levels in bacteraemic rabbits. In patients with pneumococcal meningitis, no significant difference in CSF WBC was observed between patients with or without bacteraemia at admission (n = 103, 1740 cells/μL (123–4032) vs. n = 50, 1961 cells/μL (673–5182), respectively, P = 0.18), but there was a significant correlation between CSF and blood WBC (n = 127, Spearman rho = 0.234, P = 0.008). CONCLUSION: Our results suggest that a decrease in peripheral WBC induced by enhanced bacteraemia in pneumococcal meningitis results in an attenuated CSF pleocytosis. BioMed Central 2006-04-27 /pmc/articles/PMC1475592/ /pubmed/16643642 http://dx.doi.org/10.1186/1471-2334-6-78 Text en Copyright © 2006 ∅stergaard et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
∅stergaard, Christian
O'Reilly, Terence
Brandt, Christian
Frimodt-Møller, Niels
Lundgren, Jens D
Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis
title Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis
title_full Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis
title_fullStr Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis
title_full_unstemmed Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis
title_short Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis
title_sort influence of the blood bacterial load on the meningeal inflammatory response in streptococcus pneumoniae meningitis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1475592/
https://www.ncbi.nlm.nih.gov/pubmed/16643642
http://dx.doi.org/10.1186/1471-2334-6-78
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