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...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0251494 |
| _version_ | 1818723308649054208 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-17T21:08:28Z |
| format | Article |
| id | doaj.art-74b1f45adac84e62a49960b7283ff2c8 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T21:08:28Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-74b1f45adac84e62a49960b7283ff2c82022-12-21T21:32:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01165e025149410.1371/journal.pone.0251494Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.Yekaterina BumburidiGulmira UtepbergenovaBakhtygali YerezhepovNursulu BerdiyarovaKaldikul KulzhanovaJennifer HeadDaphne MoffettDaniel SingerPawan AngraToni WhistlerJames SejvarEncephalitis 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.https://doi.org/10.1371/journal.pone.0251494 |
| spellingShingle | 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. PLoS ONE |
| title | 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_short | 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 |
| url | https://doi.org/10.1371/journal.pone.0251494 |
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