Streptococcus suis Meningitis: A Systematic Review and Meta-analysis.

Abstract

BACKGROUND:

Streptococcus suis is the most common cause of meningitis in pork consuming and pig rearing countries in South-East Asia. We performed a systematic review of studies on S. suis meningitis to define the clinical characteristics, predisposing factors and outcome.

METHODOLOGY:

Studies published between January 1, 1980 and August 1, 2015 were identified from main literature databases and reference lists. Studies were included if they were written in West-European languages and described at least 5 adult patients with S. suis meningitis in whom at least one clinical characteristic was described.

FINDINGS:

We identified 913 patients with S. suis meningitis included in 24 studies between 1980 and 2015. The mean age was 49 years and 581 of 711 patients were male (82%). Exposure to pigs or pork was present in 395 of 648 patients (61%) while other predisposing factors were less common. 514 of 528 patients presented with fever (97%), 429 of 451 with headache (95%), 462 of 496 with neck stiffness (93%) and 78 of 384 patients (20%) had a skin injury in the presence of pig/pork contact. The case fatality rate was 2.9% and hearing loss was a common sequel occurring in 259 of 489 patients (53%). Treatment included dexamethasone in 157 of 300 (52%) of patients and was associated with reduced hearing loss in S. suis meningitis patients included in a randomized controlled trial.

CONCLUSION:

S. suis meningitis has a clear association with pig and pork contact. Mortality is low, but hearing loss occurs frequently. Dexamethasone was shown to reduce hearing loss.

• Authors: Anusha van Samkar, Matthijs C Brouwer, Constance Schultsz, Arie van der Ende, Diederik van de Beek
• Journal: PLoS neglected tropical diseases (PLoS Negl Trop Dis) Vol. 9 Issue 10 Pg. e0004191 ( 2015) ISSN: 1935-2735 [Electronic] United States
• PMID: 26505485 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)

Chemical References

• Anti-Inflammatory Agents
• Dexamethasone

Topics

• Age Distribution
• Animals
• Anti-Inflammatory Agents (therapeutic use)
• Asia, Southeastern (epidemiology)
• Dexamethasone (therapeutic use)
• Environmental Exposure
• Humans
• Meningitis, Bacterial (drug therapy, epidemiology, microbiology, pathology)
• Mortality
• Occupational Exposure
• Risk Factors
• Sex Distribution
• Streptococcal Infections (drug therapy, epidemiology, microbiology, pathology)
• Streptococcus suis (isolation & purification)
• Swine