Etiologic agents of central nervous system infections among febrile hospitalized patients in the country of Georgia.

OBJECTIVES: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. METHODS: Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF) was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV) types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV), Streptococcus pneumoniae, HiB and Neisseria meningitidis. RESULTS: Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26), VZV (n = 4), and HSV-1 (n = 2). No patient was positive for mumps or HSV-2. CONCLUSIONS: Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia

Frequency of signs and symptoms among 140 patients presening with acute febrile central nervous system syndrome, country of Georgia.

<p>Frequency of signs and symptoms among 140 patients presening with acute febrile central nervous system syndrome, country of Georgia.</p

Selected characteristics of the study patients with acute central nervous system infections classified by clinical diagnosis, country of Georgia.

<p>Note: SD, standard deviation; CSF, cerebrospinal fluid.</p><p>Selected characteristics of the study patients with acute central nervous system infections classified by clinical diagnosis, country of Georgia.</p

Baseline characteristics of 140 patients presenting with febrile acute central neurologic system infections, country of Georgia.

<p>Note: SD, standard deviation.</p><p>Baseline characteristics of 140 patients presenting with febrile acute central neurologic system infections, country of Georgia.</p

Median Values and Ranges of Cereprospinal Fluid (CSF) Parameters among patients with clinically diagnosed central nervous system infections, country of Georgia.

<p>Median Values and Ranges of Cereprospinal Fluid (CSF) Parameters among patients with clinically diagnosed central nervous system infections, country of Georgia.</p