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Tubercular meningitis is one of the common causes of meningitis, which has high morbidity and mortality, but lacks sensitive diagnostic assays. The objectives of this study were to determine the causes of meningitis in adult patients by using molecular assays, to assess the risk factors associated with them, and to explore whether biomarkers can differentiate tubercular meningitis from bacterial meningitis.\nMethods: We conducted a cross-sectional study in the Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam, from June 2012 to May 2014. All patients who were ≥ 16 years old and who had meningoencephalitis suggested by abnormal cerebrospinal fluid (CSF) findings (CSF total cell \u003e5/mm3 or CSF protein ≥40 mg/dL) were included in the study. In addition to culture, CSF samples were tested for common bacterial and viral pathogens by polymerase chain reaction (PCR) and for biomarkers: C-reactive protein and adenosine deaminase (ADA).\nResults: Total number of patients admitted to the department was 7506; among them, 679 were suspected to have CNS infection, and they underwent lumbar puncture. Five hundred eighty-three patients had abnormal CSF findings (meningoencephalitis); median age was 45 (IQR 31–58), 62.6% were male, and 60.9% were tested for HIV infection. Among 408 CSF samples tested by PCR, out of them, 358 were also tested by culture; an etiology was identified in 27.5% (n=112). S. suis (8.8%), N. meningitis (3.2%), and S. pneumoniae (2.7%) were common bacterial and HSV (2.2%), Echovirus 6 (0.7%), and Echovirus 30 (0.7%) were common viral pathogens detected. M. tuberculosis was found in 3.2%. Mixed pathogens were detected in 1.8% of the CSF samples. Rural residence (aOR 4.1, 95% CI 1.2–14.4) and raised CSF ADA (≥10 IU/L) (aOR 25.5, 95% CI 3.1–212) were associated with bacterial meningitis when compared with viral meningitis; similarly, raised CSF ADA (≥10 IU/L) (aOR 42.2, 95% CI 2.0–882) was associated with tubercular meningitis.\nConclusions: Addition of molecular method to the conventional culture had enhanced the identification of etiologies of CNS infection. Raised CSF ADA (≥10 IU/L) was strongly associated with bacterial and tubercular meningitis. 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Characteristics and Biomarkers of Patients with Central Nervous System Infection Admitted to a Referral Hospital in Northern Vietnam
http://hdl.handle.net/10069/00040852
http://hdl.handle.net/10069/0004085210558acf-c547-479d-8d2f-999f2143c343
名前 / ファイル | ライセンス | アクション |
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ISYK1357_Ngo.pdf (1.1 MB)
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Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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公開日 | 2021-07-02 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Characteristics and Biomarkers of Patients with Central Nervous System Infection Admitted to a Referral Hospital in Northern Vietnam | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | CNS infection | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Meningitis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | S. suis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | HSV | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Tubercular meningitis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Biomarker | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | ADA | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Vietnam | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||
資源タイプ | doctoral thesis | |||||
アクセス権 | ||||||
アクセス権 | open access | |||||
アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||
著者 |
Ngo, Chi Cuong
× Ngo, Chi Cuong |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: Laboratory facilities for etiological diagnosis of central nervous system (CNS) infection are limited in developing countries; therefore, patients are treated empirically, and the epidemiology of the pathogens is not well-known. Tubercular meningitis is one of the common causes of meningitis, which has high morbidity and mortality, but lacks sensitive diagnostic assays. The objectives of this study were to determine the causes of meningitis in adult patients by using molecular assays, to assess the risk factors associated with them, and to explore whether biomarkers can differentiate tubercular meningitis from bacterial meningitis. Methods: We conducted a cross-sectional study in the Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam, from June 2012 to May 2014. All patients who were ≥ 16 years old and who had meningoencephalitis suggested by abnormal cerebrospinal fluid (CSF) findings (CSF total cell >5/mm3 or CSF protein ≥40 mg/dL) were included in the study. In addition to culture, CSF samples were tested for common bacterial and viral pathogens by polymerase chain reaction (PCR) and for biomarkers: C-reactive protein and adenosine deaminase (ADA). Results: Total number of patients admitted to the department was 7506; among them, 679 were suspected to have CNS infection, and they underwent lumbar puncture. Five hundred eighty-three patients had abnormal CSF findings (meningoencephalitis); median age was 45 (IQR 31–58), 62.6% were male, and 60.9% were tested for HIV infection. Among 408 CSF samples tested by PCR, out of them, 358 were also tested by culture; an etiology was identified in 27.5% (n=112). S. suis (8.8%), N. meningitis (3.2%), and S. pneumoniae (2.7%) were common bacterial and HSV (2.2%), Echovirus 6 (0.7%), and Echovirus 30 (0.7%) were common viral pathogens detected. M. tuberculosis was found in 3.2%. Mixed pathogens were detected in 1.8% of the CSF samples. Rural residence (aOR 4.1, 95% CI 1.2–14.4) and raised CSF ADA (≥10 IU/L) (aOR 25.5, 95% CI 3.1–212) were associated with bacterial meningitis when compared with viral meningitis; similarly, raised CSF ADA (≥10 IU/L) (aOR 42.2, 95% CI 2.0–882) was associated with tubercular meningitis. Conclusions: Addition of molecular method to the conventional culture had enhanced the identification of etiologies of CNS infection. Raised CSF ADA (≥10 IU/L) was strongly associated with bacterial and tubercular meningitis. This biomarker might be helpful to diagnose tubercular meningitis once bacterial meningitis is ruled out by other methods. |
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内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 長崎大学学位論文 学位記番号:博(医歯薬)甲第1357号 学位授与年月日:令和3年6月2日 | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Author: Cuong Chi Ngo, Shungo Katoh, Futoshi Hasebe, Bhim Gopal Dhoubhadel, Tomoko Hiraoka, Sugihiro Hamaguchi, Anh Thi Kim Le, Anh Thi Hien Nguyen, Anh Duc Dang, Chris Smith, Lay-Myint Yoshida, Cuong Duy Do, Thuy Thi Thanh Pham and Koya Ariyoshi | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Citation: Tropical Medicine and Health, 49, art. no. 42; 2021 | |||||
書誌情報 |
Tropical Medicine and Health 巻 49, p. 42, 発行日 2021-06-02 |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1349-4147 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1186/s41182-021-00322-2 | |||||
権利 | ||||||
権利情報 | © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
その他のタイトル | ||||||
その他のタイトル | 北ベトナムの高度医療施設に入院した中枢神経系感染症の患者の特質およびバイオマーカーについて | |||||
出版者 | ||||||
出版者 | BioMed Central Ltd | |||||
関係URI | ||||||
識別子タイプ | HDL | |||||
関連識別子 | http://hdl.handle.net/10069/00040840 | |||||
学位名 | ||||||
学位名 | 博士(医学) | |||||
学位授与機関 | ||||||
学位授与機関識別子Scheme | kakenhi | |||||
学位授与機関識別子 | 17301 | |||||
学位授与機関名 | Nagasaki University (長崎大学) | |||||
学位授与年月日 | ||||||
学位授与年月日 | 2021-06-02 | |||||
学位授与番号 | ||||||
学位授与番号 | 甲医歯薬第1357号 | |||||
学位の種類 | ||||||
課程博士 | ||||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Nagasaki University (長崎大学), 博士(医学) (2021-06-02) |