Abstract Staphylococcus condimenti (S. condimenti) is a coagulase-negative bacterium, generally regarded as not pathogenic. Indeed, S. condimenti owes its name to having been isolated from starter cultures of fermented sausage, as well as from fish and soy sauces. To the best of our knowledge, only two cases of human infection caused by this bacterium have been reported. Here, we present a case of meningitis by S. condimenti in a 65-year-old woman who was brought to hospital after having been found unconscious at home. At her arrival, she had a Glasgow coma scale = 3, fever, and hypoxic–normocapnic respiratory failure. Examination of her cerebrospinal fluid showed a slightly increased white blood cell count, normal glucose and protein concentrations. Paired cultures on blood and liquor samples yielded S. condimenti. Targeted antibiotic treatment with ceftriaxone led to a complete recovery. This unique case expands our knowledge on S. condimenti as a pathogenic bacterium.…

Sühs K, Novoselova N, Kuhn M, et al.

AbstractBackgroundThe tryptophan-kynurenine-NAD+ pathway is closely associated with regulation of immune cells toward less inflammatory phenotypes and may exert neuroprotective effects. Investigating its regulation in CNS infections would improve our understanding of pathophysiology and end-organ damage, and, furthermore, open doors to its evaluation as a source of diagnostic and/or prognostic biomarkers.MethodsWe measured concentrations of kynurenine (Kyn) and tryptophan (Trp) in 220 cerebrospinal fluid samples from patients with bacterial and viral (herpes simplex, varicella zoster, enteroviruses) meningitis/encephalitis, neuroborreliosis, autoimmune neuroinflammation (anti-NMDA-R encephalitis, multiple sclerosis), and noninflamed controls (Bell’s palsy, normal pressure hydrocephalus, Tourette syndrome).ResultsKyn concentrations correlated strongly with CSF markers of neuroinflammation (leukocyte count, lactate, and blood-CSF-barrier dysfunction) and were highly increased in bacterial and viral CNS infections, but were low or undetectable in anti-NMDA-R encephalitis, multiple sclerosis, and controls. Trp was decreased mostly in viral CNS infections and neuroborreliosis. Multiple logistic regression analysis revealed combinations of Kyn, Trp and Kyn/Trp ratio with leukocyte count or lactate as accurate classifiers for the clinically important differentiation between neuroborreliosis, viral CNS infections, and autoimmune neuroinflammation. ConclusionsThe Trp-Kyn-NAD+ pathway is activated in CNS infections and provides highly accurate CSF biomarkers, particularly when combined with standard CSF indices of neuroinflammation.

Laura V. Cooper, Anna Robson, Caroline L. Trotter, Abraham Aseffa, Jean‐Marc Collard, Doumagoum Moto Daugla, Aldiouma Diallo, Abraham Hodgson, Jean‐François Jusot, Babatunji Omotara, Samba Sow, Musa Hassan‐King, Olivier Manigart, Maria Nascimento, Arouna Woukeu, Daniel Chandramohan, Ray Borrow, Martin C. J. Maiden, Brian Greenwood, on behalf of James M. Stuart, the MenAfriCar Consortium, Oumer Ali, Ahmed Bedru, Tsehaynesh Lema, Tesfaye Moti, Yenenesh Tekletsion, Alemayehu Worku,

Abstract Objective To investigate potential risk factors for acquisition in seven countries of the meningitis belt. Methods Households were followed up every 2 weeks for 2 months, then monthly for a further 4 months. Pharyngeal swabs were collected from all available household members at each visit and questionnaires completed. Risks of acquisition over the whole study period and for each visit were analysed by a series of logistic regressions. Results Over the course of the study, acquisition was higher in: (i) 5‐to 14‐year olds, as compared with those 30 years or older (OR 3.6, 95% CI 1.4–9.9); (ii) smokers (OR 3.6, 95% CI 0.98–13); and (iii) those exposed to wood smoke at home (OR 2.6 95% CI 1.3–5.6). The risk of acquisition from one visit to the next was higher in those reporting a sore throat during the dry season (OR 3.7, 95% CI 2.0–6.7) and lower in those reporting antibiotic use (OR 0.17, 95% CI 0.03–0.56). Conclusions Acquisition of meningococcal carriage peaked in school age children. Recent symptoms of sore throat during the dry season, but not during the rainy season, were associated with a higher risk of acquisition. Upper respiratory tract infections may be an important driver of epidemics in the meningitis belt.

Colicchio, R., Pagliuca, C., Ricci, S., Scaglione, E., Grandgirard, D., Masouris, I., Farina, F., Pagliarulo, C., Mantova, G., Paragliola, L., Leib, S. L., Koedel, U., Pozzi, G., Alifano, P., Salvatore, P.

In serogroup C Neisseria meningitidis, the cssA (siaA) gene codes for an UDP-N-acetylglucosamine 2-epimerase that catalyzes the conversion of UDP-N-acetyl-α-D-glucosamine into N-acetyl-D-mannosamine and UDP in the first step in sialic acid biosynthesis. This enzyme is required for the biosynthesis of the (α2->9)-linked polysialic acid capsule and for lipooligosaccharide (LOS) sialylation. In this study, we have used a reference serogroup C meningococcal strain and an isogenic cssA knockout mutant to investigate the pathogenetic role of surface-exposed sialic acids in a model of meningitis based on intracisternal inoculation of BALB/c mice. Results confirmed the key role of surface-exposed sialic acids in meningococcal pathogenesis. The 50% lethal dose (LD50) of the wild type strain 93/4286 was about four orders of magnitude lower than that of the cssA mutant. Compared to the wild type strain, the ability of this mutant to replicate in brain and spread systemically was severely impaired. Evaluation of brain damage evidenced a significant reduction in cerebral hemorrhages in mice infected with the mutant in comparison with those challenged with the wild type strain. Histological analysis showed the typical features of bacterial meningitis, including inflammatory cells in the subarachnoid, perivascular and ventricular spaces especially in animals infected with the wild type. Noticeably, 80% of mice infected with the wild type strain presented with massive bacterial localization and accompanying inflammatory infiltrate in the corpus callosum, indicating high tropism of meningococci exposing sialic acids toward this brain structure and a specific involvement of the corpus callosum in the mouse model of meningococcal meningitis.…