Central Nervous System Infections (Central Nervous System Infection)

Pathogenic infections of the brain, spinal cord, and meninges. DNA VIRUS INFECTIONS; RNA VIRUS INFECTIONS; BACTERIAL INFECTIONS; MYCOPLASMA INFECTIONS; SPIROCHAETALES INFECTIONS; fungal infections; PROTOZOAN INFECTIONS; HELMINTHIASIS; and PRION DISEASES may involve the central nervous system as a primary or secondary process.

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Networked: 1390 relevant articles (89 outcomes, 110 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infections
2.	Meningitis
3.	Acquired Immunodeficiency Syndrome (AIDS)
4.	Bacterial Meningitis
5.	Central Nervous System Infections (Central Nervous System Infection)

Experts

1.	Nau, Roland: 13 articles (07/2022 - 06/2003)
2.	Price, Richard W: 12 articles (01/2022 - 03/2005)
3.	Hagberg, Lars: 10 articles (01/2022 - 06/2010)
4.	Studahl, Marie: 9 articles (12/2019 - 04/2011)
5.	Gisslén, Magnus: 7 articles (01/2022 - 12/2010)
6.	Fuchs, Dietmar: 7 articles (12/2021 - 06/2010)
7.	Zetterberg, Henrik: 7 articles (12/2021 - 12/2012)
8.	Singhi, Pratibha: 7 articles (12/2020 - 02/2002)
9.	Grahn, Anna: 7 articles (12/2019 - 08/2011)
10.	Newton, Paul N: 7 articles (12/2019 - 08/2011)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Central Nervous System Infections:

1.	Anti-Bacterial Agents (Antibiotics)IBA 11/28/2022 - "Despite increasing observational data showing low CNS penetration of various antibiotics, there are few clinical studies describing practical implementation of TDM in management of CNS infection. " 11/28/2022 - "Studies were included if they described adults treated for a suspected/confirmed bacterial CNS infection and had antibiotic drug concentration(s) determined that affected individual treatment. " 12/17/2020 - "The goal of our study was to determine how EV and PeV CSF RT-PCR testing impacted the duration of antibiotic use and the length of hospitalization (LOS) in children ≤6 months old with suspected CNS infection. " 01/01/2018 - "The study characterized all the CNS infections over the 30-month period and compared the time to organism identification and antibiotic management before and after the introduction of the multiplex assay. " 04/01/1992 - "The factors influencing changes in the antibiotic susceptibility and the aetiology of CNS infection require further study."
2.	Linezolid (Zyvox)FDA Link 09/01/2011 - "Linezolid is effective against methicillin-resistant Staphylococcus aureus, which may cause central nervous system (CNS) infections, but drug concentrations in plasma are characterized by a large inter-patient variability. " 01/01/2004 - "This observation seems to confirm previous reports of the efficacy of linezolid for the treatment of central nervous system infections caused by multidrug resistant Gram-positive bacteria. " 09/01/2014 - "Despite the need for more experimental data, our results suggest that linezolid and its combinations could be considered as a potential alternative in difficult-to-treat CNS infections and especially in those due to GISA strains and deserve more studies." 04/01/2012 - "Good activity of linezolid in CSF supports performance of clinical trials evaluating its potential for treatment of CNS infections." 06/01/2007 - "Clinical trials to address the role of linezolid in CNS infections are urgently needed."
3.	Antiviral Agents (Antivirals)IBA 01/01/2014 - "The drug-drug interactions between the antiretrovirals and the antivirals, as well as the effects of alcohol on drug metabolism, complicate existing models of CNS penetration, making it difficult to assess the efficacy of treatment on CNS infection. " 10/18/2023 - "Although no animal model can replicate all aspects of any human disease, mouse polyomavirus (MuPyV) in mice and JCPyV in humans share key features of peripheral and CNS infection and antiviral immunity. " 10/16/2023 - "This case supports the use of antiviral prophylaxis in patients surviving a confirmed BV central nervous system infection. " 05/26/2020 - "Implementing the ME panel in-house for adults undergoing an LP for a suspected community-onset CNS infection significantly reduced the HSV PCR TAT, antiviral DOT, total antimicrobial DOT, and hospital LOS." 01/01/2020 - "Effective Antiviral Medicinal Plants and Biological Compounds Against Central Nervous System Infections: A Mechanistic Review."
4.	Colistin (Coly-Mycin)FDA Link 01/01/2023 - "IV combined with IVT colistin sulfate is effective in the treatment of CNS infections caused by CRAB. " 01/01/2016 - "When CNS infections are caused by multi-drug resistant Gram-negative bacteria, intrathecal colistin is considered an effective and safe option. " 10/01/2014 - "Based on our comprehensive review of the relevant literature relating to both clinical and pharmacokinetic data, we conclude that the intrathecal/intraventricular administration of colistin is a safe and effective option to treat central nervous system infections caused by multidrug-resistant Gram-negative bacteria. " 03/01/2021 - "In conclusion, this is the first study of colistin pharmacokinetics in CSF after IVT administration alone in patients with CNS infection. " 02/01/2017 - "Only patients with CNS infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii treated with intrathecal colistin were included in this study. "
5.	VancomycinFDA LinkGeneric 01/01/2022 - "Conclusion: Using vancomycin to treat CNS infections appears effective and safe based on current evidence. " 01/01/2002 - "[The efficacy of intraventricularly administered vancomycin in the case of central nervous system infection caused by enterococcus faecalis]." 01/01/2022 - "Objective: The decision of vancomycin dosage for central nervous system (CNS) infections is still a challenge because its bactericidal nature in cerebrospinal fluid (CSF) has not been confirmed by human studies. " 01/01/2022 - "Additionally, few studies on vancomycin's pharmacokinetics (PK) in CSF for CNS infections. " 01/01/2023 - "Fourteen adult patients (9 with primary CNS infection) were treated with vancomycin intravenously. "
6.	Voriconazole (Vfend)FDA LinkGeneric 01/01/2021 - "Conclusion: Voriconazole is a relatively safe and effective alternative treatment for Candida CNS infection in preterm infants. " 06/01/2011 - "The efficacy of voriconazole against fungal central nervous system (CNS) infections was examined retrospectively. " 06/01/2011 - "The efficacy of voriconazole in the treatment of 192 fungal central nervous system infections: a retrospective analysis." 07/01/2007 - "Efficacy of voriconazole in a murine model of cryptococcal central nervous system infection." 01/01/2021 - "Objective: The aim of the study was to observe the clinical efficacy and safety of intravenous and oral sequential treatment with voriconazole for Candida central nervous system (CNS) infection in premature infants. "
7.	CytokinesIBA 10/01/2023 - "The inflammatory response in the subarachnoid space, modulated by different cytokines, plays a major role in the pathogenesis of acute central nervous system infections. " 04/01/2020 - "The excessive activation of immune response characterized by elevated levels of CSF Th1-, Th2- and Th17-type cytokines has been observed during CNS infection. " 04/01/2020 - "Furthermore, the correlation between CSF cytokines and CSF parameters in CNS infection was analyzed. " 04/01/2020 - "We have attempted to investigate cytokine profiles in cerebrospinal fluid (CSF) of patients with CNS infection. " 04/01/2020 - "Different cytokine profiles may be presented in central nervous system (CNS) infection due to different pathogens. "
8.	DNA (Deoxyribonucleic Acid)IBA 11/01/1997 - "We conclude that PCR detection of HSV DNA in CSF specimens should be considered an emerging "gold standard" for the laboratory diagnosis of CNS infections with this virus." 07/01/2021 - "The gold standard method to detect HSV-DNA in cerebrospinal fluid (CSF) and diagnose a CNS infection is the polymerase chain reaction (PCR). " 10/30/2023 - "The detection of EBV DNA may represent active central nervous system (CNS) infection, reactivation in the setting of another CNS pathogen or due to impaired immunity, or detection of quiescent virus. " 11/01/2022 - "Higher EBV-DNA load in peripheral blood was correlated with EBV-CNS infection (P < 0.001). " 01/01/2022 - "Among 57 patients with EBV DNA detected in CSF, 51 (89.5%) were diagnosed with CNS infection or inflammatory disorders. "
9.	Penicillins (Penicillin)FDA Link 02/01/2013 - "Sixty years after the death of Sir Hugh Cairns, we present archive material of historical interest from the Radcliffe Infirmary in Oxford from the time of his first trials of penicillin for CNS infection. " 02/01/2007 - "In the 39 patients in whom the responsible pathogen was isolated, those predominantly responsible for the CNS infections were: penicillin-nonsusceptible Streptococcus pneumoniae (7; 17.9%), vancomycin-resistant enterococci (6; 15.4%), Nocardia spp. (5; 12.8%), methicillin-resistant Staphylococcus epidermidis (4; 10.3%), and methicillin-resistant Staphylococcus aureus (3; 7.7%). " 02/01/1979 - "Our experience and that of others suggest that (1) penicillin susceptibility testing of significant pneumococcal isolates should become routine; (2) penicillin may not be adequate therapy for CNS infections due to pneumococci whose penicillin minimal inhibitory concentration is greater than 0.1 microgram/ml; and (3) long-term penicillin "prophylaxis" may be inappropriate in the splenectomized patient in areas where these organisms are prevalent." 06/20/1958 - "[Usefulness & efficacy of parenteral penicillin administration & of other antibiotics in bacterial CNS infections]." 03/01/1978 - "Four premature infants under 1,500 g were treated with parenteral chloramphenicol for central nervous system infections due to organisms resistant to the penicillins. "
10.	Ceftriaxone (Ceftriaxon)FDA LinkGeneric 01/01/2020 - "The objective of this study was to determine the impact of ceftriaxone dosing on clinical outcomes among ICU patients without central nervous system (CNS) infection. " 01/01/2020 - "A retrospective study of ICU patients receiving intravenous, empirical ceftriaxone for non-CNS infections was conducted. " 01/01/2019 - "High dosages of ceftriaxone are used to treat central nervous system (CNS) infections. " 01/01/2019 - "High-dose ceftriaxone for CNS infection administered as recommended by French guidelines in adults was well tolerated overall, suggesting these recommendations could be applied and generalized. " 01/01/2019 - "Tolerability of high-dose ceftriaxone in CNS infections: a prospective multicentre cohort study."

Therapies and Procedures

1.	Therapeutics 11/01/2006 - "Mortality of CNS infections by HSV in childhood has been improved since early diagnosis by polymerase chain reaction and anti-viral therapies have been established. " 10/01/2004 - "It is proposed that an enhanced understanding of microglia will yield improved therapies of central nervous system infections, since such therapies are, by and large, sorely needed." 01/01/1996 - "One patient died 8 days after the end of therapy, the central nervous system infection had already been cured, and the remaining patients recovered without relapses." 05/01/2023 - "This study showed that CZA-based combination therapy is an effective treatment option for CNS infections caused by CRKP." 01/01/2010 - "Many of the studies addressing the relevant pharmacological and microbiological aspects of antimicrobial therapy for CNS infections have been performed in experimental animal models and, as a result, the information derived from these studies may be different when examined in appropriate human studies. "
2.	Craniotomy 01/01/2008 - "The authors reviewed the medical records and imaging studies in all patients who underwent a craniotomy or stereotactic drainage for CNS infection over the past 10 years. " 12/30/2022 - "Post-operative central nervous system infections (PCNSIs) are serious complications of craniotomy. " 07/01/2018 - "Multivariable analysis showed that any clinical risk factor (p = 0.02) and headache (p = 0.02) predicted improved outcome whereas systemic or CNS infection (p = 0.02) and craniectomy (p = 0.02) predicted poor outcome. " 06/01/2023 - "To develop and evaluate a nomogram to predict CNS infections in patients with severe traumatic brain injury (sTBI) after craniotomy. " 06/01/2023 - "Prediction model of central nervous system infections in patients with severe traumatic brain injury after craniotomy."
3.	Liver Transplantation 08/27/2013 - "Standard preventive and diagnostic protocols have helped to reduce the prevalence of opportunistic central nervous system (CNS) infections, but viral and fungal CNS infections still affect 1% of liver transplant recipients, and the morbidity and mortality in the affected patients remain fairly high. " 03/01/2015 - "Central nervous system (CNS) infections after liver transplantation may be fungal in aetiology, with involvement from either common organisms such as Cryptococcus neoformans and Aspergillus spp. as well as less common organisms, such as the Mucorales and Scedosporium spp. Although the mortality of CNS fungal infections was nearly 100% in early series, more recent data has suggested that good outcomes can be achieved. "
4.	Drug Therapy (Chemotherapy) 07/14/2023 - "We included non-randomized studies (NRS) and randomized control trials (RCT) of pharmacotherapy versus placebo, drug, or a combination of drugs in adults with primary CNS infection. " 01/01/2019 - "The mortality rate is high with the CNS infections caused by these microbes despite modern developments in healthcare and antimicrobial chemotherapy. " 03/01/2017 - "Pharmacotherapies designed to suppress TNFR1-mediated or augment TNFR2-mediated effects of TNFα may provide antiseizure and disease-modifying effects after central nervous system infection." 02/01/1991 - "None of the patients had records of long term cytotoxic chemotherapy, radiotherapy or central nervous system infection. " 07/14/2023 - "This research synthesized scientific evidence on the use of pharmacotherapy as intervention to reduce cognitive impairments in adult patients with primary central nervous system (CNS) infections. "
5.	Catheters 02/09/2021 - "External ventricular drainage (EVD) could promptly reduce intracranial pressure by diverting cerebrospinal fluid and intraventricular blood; however, the incidence of complications such as central nervous system infection, catheter occlusion and rebleeding are relatively common. " 09/01/2017 - "For the remaining 16 patients of this group, CNS infection, colonization of the catheter and sample contamination were diagnosed via PCR alone. " 09/01/2017 - "Using cultures, CNS infection was diagnosed in 8 patients, colonization of the drainage catheter in 6 patients, and sample contamination in 7 patients. " 06/01/2015 - "Over 10 years, 265 intracranial pressure catheters were placed in 259 patients, mainly for acute CNS infections (n = 242, 93.4%). " 12/15/2005 - "aureus is a common pathogen in skin, soft-tissue, catheter-related, bone, joint, pulmonary, and central nervous system infections. "