Bacterial meningitis is one of the most common infectious diseases affecting neonates (7). It is characterized by the inflammation of the meninges caused by the presence of bacteria or bacterial products within the subarachnoid space of the brain, the spinal cord and the ventricular system (16, 22). This inflammatory response can eventually lead to various forms of brain damage (16, 26).
Untreated neonatal bacterial meningitis (NBM) almost always results in death (22), and despite the development of new treatments and supportive care over the past few decades, mortality and morbidity remain high worldwide (7, 13, 16, 22). Furthermore, around 30% of the survivors carry neurological sequelae, such as cerebral palsy, mental retardation, epilepsy …show more content…
Many pathogens have the potential to become invasive and cause systemic infection (22), but the most common meningitis-causing organisms are characterized by the possession of a polysaccharide capsule, which is essential for infection (35). More than 80% of NBM cases are caused by Group B Streptococcus and Escherichia coli K1 (7, 13, 22).
E. coli is one of the main components of the commensal intestinal microbiota of humans. However, they also have huge pathogenic potential, capable of causing a broad range of diseases including gastrointestinal and urinary tract infections, systemic infection and meningitis (7). Neonates, especially those within the first 28 days of life, are particularly susceptible to E. coli meningitis and sepsis (7, 13, 35). Risk factors identified so far are low birth weight, prematurity, a high level of bacteremia and the absence of opsonizing and bactericidal antibodies against E. coli serotype K1 capsule (7, 20, …show more content…
coli K1 infection is not fully understood yet (7, 20, 37), and this hinders the development of more efficient therapies and prevention strategies (20). It is a complex, multi-step process, which begins with transmission of E. coli K1 from mother to infant during or shortly after birth, with subsequent colonization of the gastrointestinal mucosa, translocation across the gastrointestinal epithelium, entry into the bloodstream and invasion of other bodily sites (37, Fig.1). Bacteria may then cross the blood-brain barrier (BBB), and invade the Central Nervous System (CNS) causing meningitis (21, 37). Bacterial replication within the CNS induces the release of several toxic compounds and pro-inflammatory molecules (37). This increases the permeability of the BBB, inducing the migration of white blood cells across the barrier, which eventually leads to the inflammation of the meninges that is characteristic of this disease
Untreated neonatal bacterial meningitis (NBM) almost always results in death (22), and despite the development of new treatments and supportive care over the past few decades, mortality and morbidity remain high worldwide (7, 13, 16, 22). Furthermore, around 30% of the survivors carry neurological sequelae, such as cerebral palsy, mental retardation, epilepsy …show more content…
Many pathogens have the potential to become invasive and cause systemic infection (22), but the most common meningitis-causing organisms are characterized by the possession of a polysaccharide capsule, which is essential for infection (35). More than 80% of NBM cases are caused by Group B Streptococcus and Escherichia coli K1 (7, 13, 22).
E. coli is one of the main components of the commensal intestinal microbiota of humans. However, they also have huge pathogenic potential, capable of causing a broad range of diseases including gastrointestinal and urinary tract infections, systemic infection and meningitis (7). Neonates, especially those within the first 28 days of life, are particularly susceptible to E. coli meningitis and sepsis (7, 13, 35). Risk factors identified so far are low birth weight, prematurity, a high level of bacteremia and the absence of opsonizing and bactericidal antibodies against E. coli serotype K1 capsule (7, 20, …show more content…
coli K1 infection is not fully understood yet (7, 20, 37), and this hinders the development of more efficient therapies and prevention strategies (20). It is a complex, multi-step process, which begins with transmission of E. coli K1 from mother to infant during or shortly after birth, with subsequent colonization of the gastrointestinal mucosa, translocation across the gastrointestinal epithelium, entry into the bloodstream and invasion of other bodily sites (37, Fig.1). Bacteria may then cross the blood-brain barrier (BBB), and invade the Central Nervous System (CNS) causing meningitis (21, 37). Bacterial replication within the CNS induces the release of several toxic compounds and pro-inflammatory molecules (37). This increases the permeability of the BBB, inducing the migration of white blood cells across the barrier, which eventually leads to the inflammation of the meninges that is characteristic of this disease