Streptococcus suis-Associated Meningitis, Bali, Indonesia, 2014-2017

Emerg Infect Dis. 2019 Dec;25(12):2235-2242. doi: 10.3201/eid2512.181709.

Abstract

Streptococcus suis is an emerging agent of zoonotic bacterial meningitis in Asia. We describe the epidemiology of S. suis cases and clinical signs and microbiological findings in persons with meningitis in Bali, Indonesia, using patient data and bacterial cultures of cerebrospinal fluid collected during 2014-2017. We conducted microbiological assays using the fully automatic VITEK 2 COMPACT system. We amplified and sequenced gene fragments of glutamate dehydrogenase and recombination/repair protein and conducted PCR serotyping to confirm some serotypes. Of 71 cases, 44 were confirmed as S. suis; 29 isolates were serotype 2. The average patient age was 48.1 years, and 89% of patients were male. Seventy-seven percent of patients with confirmed cases recovered without complications; 11% recovered with septic shock, 7% with deafness, and 2% with deafness and arthritis. The case-fatality rate was 11%. Awareness of S. suis infection risk must be increased in health promotion activities in Bali.

Keywords: Bali; Indonesia; Streptococcus suis; bacteria; human; meningitis/encephalitis; pork; swine; zoonoses.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bacterial Proteins / genetics
  • Biomarkers
  • DNA Restriction Enzymes / genetics
  • Female
  • Geography, Medical
  • History, 21st Century
  • Humans
  • Indonesia / epidemiology
  • Male
  • Meningitis, Pneumococcal / diagnosis
  • Meningitis, Pneumococcal / epidemiology*
  • Meningitis, Pneumococcal / history
  • Meningitis, Pneumococcal / microbiology*
  • Middle Aged
  • Phylogeny
  • Polymerase Chain Reaction
  • Public Health Surveillance
  • Serotyping
  • Streptococcus suis* / classification
  • Streptococcus suis* / genetics
  • Streptococcus suis* / isolation & purification
  • Symptom Assessment

Substances

  • Bacterial Proteins
  • Biomarkers
  • DNA Restriction Enzymes
  • RecN protein, Bacteria