Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settings
Objectives: This study investigated the impact of causative pathogens on the outcomes of central nervous system (CNS) infections and assessed clinical parameters to identify patients at risk for unfavourable outcomes. Methods: Patients with suspected CNS infections underwent blood and cerebrospinal...
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Elsevier
2025-10-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225002267 |
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| author | Do Van Dong Vu Viet Sang Nghiem Xuan Hoan Nguyen Viet Ha Nguyen Thi Khanh Linh Bui Tien Sy Nguyen Trong The Hoang Xuan Quang Tran Thi Lien Van Dinh Trang Peter G. Kremsner Le Huu Song Silke Peter Dennis Nurjadi Thirumalaisamy P. Velavan |
| author_facet | Do Van Dong Vu Viet Sang Nghiem Xuan Hoan Nguyen Viet Ha Nguyen Thi Khanh Linh Bui Tien Sy Nguyen Trong The Hoang Xuan Quang Tran Thi Lien Van Dinh Trang Peter G. Kremsner Le Huu Song Silke Peter Dennis Nurjadi Thirumalaisamy P. Velavan |
| author_sort | Do Van Dong |
| collection | DOAJ |
| description | Objectives: This study investigated the impact of causative pathogens on the outcomes of central nervous system (CNS) infections and assessed clinical parameters to identify patients at risk for unfavourable outcomes. Methods: Patients with suspected CNS infections underwent blood and cerebrospinal fluid (CSF) culture and advanced molecular testing, including real-time PCR assays for bacterial and viral pathogens. Patients were classified into clinical categories and their outcomes assessed using the Glasgow Outcome Scale. Results: Pathogens were identified in 24% (80/330) of patients, with Mycobacterium tuberculosis, Klebsiella pneumoniae, and Acinetobacter baumannii being the most common. Mortality was 10%, with fungal meningitis and dual infections having the highest rates. Unfavourable outcomes were observed in 57% of patients. The most common pathogens associated with unfavourable outcomes were M. tuberculosis followed by K. pneumoniae, A. baumannii, and HSV-1. Multivariate analysis identified community-onset infection as a protective factor, while a longer duration of illness before admission (≥5 days) and altered mental status on admission were significant predictors for unfavourable outcomes. Furthermore, the timely administration of appropriate empirical therapy was significantly associated with a reduced risk of mortality. Conclusions: CNS infections in northern Vietnam have diverse causes and overlapping clinical features, complicating diagnosis and management. |
| format | Article |
| id | doaj-art-447b19beb4c34e42b7bb1e2f0c9159e8 |
| institution | Kabale University |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-447b19beb4c34e42b7bb1e2f0c9159e82025-08-23T04:47:40ZengElsevierInternational Journal of Infectious Diseases1201-97122025-10-0115910800210.1016/j.ijid.2025.108002Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settingsDo Van Dong0Vu Viet Sang1Nghiem Xuan Hoan2Nguyen Viet Ha3Nguyen Thi Khanh Linh4Bui Tien Sy5Nguyen Trong The6Hoang Xuan Quang7Tran Thi Lien8Van Dinh Trang9Peter G. Kremsner10Le Huu Song11Silke Peter12Dennis Nurjadi13Thirumalaisamy P. Velavan14Institute of Tropical Medicine, University of Tübingen, and German Center for Infection Research (DZIF), Tübingen, Germany; 108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam103 Military Hospital, Hanoi, VietnamViet Tiep Friendship Hospital, Haiphong, Vietnam; Hai Phong University of Medicine and Pharmacy, Haiphong, VietnamNational Hospital for Tropical Diseases, Hanoi, VietnamInstitute of Tropical Medicine, University of Tübingen, and German Center for Infection Research (DZIF), Tübingen, Germany; Centre de Recherches Médicales de Lambaréné (CERMEL), GabonInstitute of Tropical Medicine, University of Tübingen, and German Center for Infection Research (DZIF), Tübingen, Germany; 108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, VietnamInstitute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, GermanyInstitute of Medical Microbiology, University of Lübeck and University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Lübeck, GermanyInstitute of Tropical Medicine, University of Tübingen, and German Center for Infection Research (DZIF), Tübingen, Germany; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam; Faculty of Medicine, Duy Tan University, Danang, Vietnam; Correspondence: Thirumalaisamy P Velavan, Institute of Tropical Medicine, Wilhemstr. 27, 72074, Tübingen, Germany.Objectives: This study investigated the impact of causative pathogens on the outcomes of central nervous system (CNS) infections and assessed clinical parameters to identify patients at risk for unfavourable outcomes. Methods: Patients with suspected CNS infections underwent blood and cerebrospinal fluid (CSF) culture and advanced molecular testing, including real-time PCR assays for bacterial and viral pathogens. Patients were classified into clinical categories and their outcomes assessed using the Glasgow Outcome Scale. Results: Pathogens were identified in 24% (80/330) of patients, with Mycobacterium tuberculosis, Klebsiella pneumoniae, and Acinetobacter baumannii being the most common. Mortality was 10%, with fungal meningitis and dual infections having the highest rates. Unfavourable outcomes were observed in 57% of patients. The most common pathogens associated with unfavourable outcomes were M. tuberculosis followed by K. pneumoniae, A. baumannii, and HSV-1. Multivariate analysis identified community-onset infection as a protective factor, while a longer duration of illness before admission (≥5 days) and altered mental status on admission were significant predictors for unfavourable outcomes. Furthermore, the timely administration of appropriate empirical therapy was significantly associated with a reduced risk of mortality. Conclusions: CNS infections in northern Vietnam have diverse causes and overlapping clinical features, complicating diagnosis and management.http://www.sciencedirect.com/science/article/pii/S1201971225002267Central nervous system infectionsBacterial meningitisTuberculous meningitisViral encephalitis/meningitisFungal meningitisVietnam |
| spellingShingle | Do Van Dong Vu Viet Sang Nghiem Xuan Hoan Nguyen Viet Ha Nguyen Thi Khanh Linh Bui Tien Sy Nguyen Trong The Hoang Xuan Quang Tran Thi Lien Van Dinh Trang Peter G. Kremsner Le Huu Song Silke Peter Dennis Nurjadi Thirumalaisamy P. Velavan Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settings International Journal of Infectious Diseases Central nervous system infections Bacterial meningitis Tuberculous meningitis Viral encephalitis/meningitis Fungal meningitis Vietnam |
| title | Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settings |
| title_full | Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settings |
| title_fullStr | Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settings |
| title_full_unstemmed | Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settings |
| title_short | Causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource-limited settings |
| title_sort | causative pathogens and predictors of unfavourable outcomes in central nervous system infections in resource limited settings |
| topic | Central nervous system infections Bacterial meningitis Tuberculous meningitis Viral encephalitis/meningitis Fungal meningitis Vietnam |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225002267 |
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