Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
Aetiologies of Central Nervous System Infection in Viet Nam: A Prospective Provincial Hospital-Based Descriptive Surveillance Study
by Nghia Ho Dang Trung, Tu Le Thi Phuong, Marcel Wolbers, Hoang Nguyen Van Minh, Vinh Nguyen Thanh, Minh Pham Van, Nga Tran Vu Thieu, Tan Le Van, Diep To Song, Phuong Le Thi, Thao Nguyen Thi Phuong, Cong Bui Van, Vu Tang, Tuan Hoang Ngoc Anh, Dong Nguyen, Tien Phan Trung, Lien Nguyen Thi Nam, Hao Tran Kiem, Tam Nguyen Thi Thanh, James Campbell, Maxine Caws, Jeremy Day, Menno D. de Jong, Chau Nguyen Van Vinh, H. Rogier Van Doorn, Hien Tran Tinh, Jeremy Farrar, Constance Schultsz, the VIZIONS CNS Infection Network
Background
Infectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.
Methods
We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007? April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.
Results
We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52%) of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24%) and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%). Mycobacterium tuberculosis was confirmed in 34/617 (6%) adult patients and 11/624 (2%) paediatric patients. The acute case fatality rate (CFR) during hospital admission was 73/617 (12%) in adults and to 42/624 (7%) in children.
Conclusions
Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.
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Background
Infectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.
Methods
We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007? April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.
Results
We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52%) of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24%) and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%). Mycobacterium tuberculosis was confirmed in 34/617 (6%) adult patients and 11/624 (2%) paediatric patients. The acute case fatality rate (CFR) during hospital admission was 73/617 (12%) in adults and to 42/624 (7%) in children.
Conclusions
Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.