الفهرس 
Meningitis
Community acquired meningitisOnly 14 pages are availabe for public view
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Abstract
Bacterial meningitis is one of the serious communicable diseases usually associated with substantial morbidity and mortality rates . About 10 to 20% of survivors develop disabling neurologic complications mandating the prompt diagnosis, treatment, and prevention (Khater and Elabd, 2016). Direct microscopic examination and CSF culture are still considered the gold standard for diagnosis of bacterial meningitis. However, results of culture may only be available after 24 to 48h and when the number of viable organisms in the CSF is low, it may take even longer. Moreover, the sensitivity of microscopic examination and culture of CSF can be debated, especially after the start of antibiotic treatment and in cases caused by fastidious, slow-growing or anaerobic microorganisms. So, 16S rDNA PCR and sequencing have been used to provide an early and accurate diagnosis of bacterial meningitis (Sarookhani et al.,2010). The aim of this study was to evaluate the diagnosis of culture negative acute bacterial meningitis by using 16S rDNA-based gene sequencing applied directly on CSF samples, in order to identify the causative bacterial species for the proper choice of subsequent antimicrobial therapy. This study was carried out on two groups: group I (patients group) which included 30 patients expected to have acute bacterial meningitis and group II (control group) which included 7 patients who were expected to have viral meningitis. group I was further subdivided into 15 patients with community acquired infection isolated in Tanta Hospital of Infectious Diseases and 15 infants with hydrocephalus who were admitted to Neurosurgery Department of Tanta University Hospital with application of VP shunt. It was performed in the Microbiology & Immunology Department, Faculty of Medicine, Tanta University during the period from September 2016 till February 2018. All participants were subjected to the followings: I-Complete history taking: included age, sex , onset and duration of symptoms of meningits and antibitics used. II-Clinical assesment: signs of meningeal irritation were searched for. III-Sample collection: CSF samples were collected either by lumbar puncture in community acquired meningitis or by ventricular tapping in VP shunt related meningitis under complete aseptic technique. Blood samples were obtained by venipuncture under complete aseptic technique from only patients with community acquired meningitis for blood culture. For each CSF sample, one tube was used uncentrifuged for total WBCs count. A second tube was used uncentrifuged for macroscopic examination then, it was centrifuged and the supernatant was transferred to another tube to be used for glucose and protein measurement while the sediment was used for bacteriological examination (Gram’s stained film,isolation and identification). A third frozen tube was used for 16S rDNA detection and sequencing by using the MicroSeq 500 Bacterial Identification Kit and cycle sequencing. The resulting DNA sequences were analyzed in order to identify the bacterial species by using NCBI BLAST (https://blast.ncbi.nlm.nih.gov).