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

• Published in: Emerging infectious diseases Vol. 25; no. 12; pp. 2235 - 2242
• Main Authors: Susilawathi, Ni Made, Tarini, Ni Made Adi, Fatmawati, Ni Nengah Dwi, Mayura, Putu I.B., Suryapraba, Anak Agung Ayu, Subrata, Made, Sudewi, Anak Agung Raka, Mahardika, Gusti Ngurah
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.12.2019; Centers for Disease Control and Prevention
• Subjects: Adult; Aged; Arthritis; Associated Meningitis, Bali, Indonesia, 2014–2017; bacteria; Bacterial meningitis; Bacterial Proteins - genetics; Bali; Biomarkers; Deafness; DNA Restriction Enzymes - genetics; Epidemiology; Female; Genes; Genetic research; Geography, Medical; Glutamate; History, 21st Century; human; Humans; Indonesia; Indonesia - epidemiology; Male; Meningitis; Meningitis, Pneumococcal - diagnosis; Meningitis, Pneumococcal - epidemiology; Meningitis, Pneumococcal - history; Meningitis, Pneumococcal - microbiology; Microbiology; Middle Aged; Phylogeny; Polymerase Chain Reaction; Public Health Surveillance; Septic shock; Serotyping; Shock; Streptococcus suis; Streptococcus suis - classification; Streptococcus suis - genetics; Streptococcus suis - isolation & purification; Symptom Assessment; Indonesia; Southeast Asia; Thailand; Maryland; swine; Bali; bacteria; Streptococcus suis; zoonoses; pork; human; meningitis/encephalitis; Indonesia
• DOI: 10.3201/eid2512.181709
• ISSN: 1080-6040; 1080-6059

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.