Affiliation:
1. Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21287
Abstract
Escherichia coli
is the most common Gram-negative bacillary organism causing meningitis, and
E. coli
meningitis continues to be an important cause of mortality and morbidity throughout the world. Our incomplete knowledge of its pathogenesis contributes to such mortality and morbidity. Recent reports of
E. coli
strains producing CTX-M-type or TEM-type extended-spectrum β-lactamases create a challenge. Studies using
in vitro
and
in vivo
models of the blood-brain barrier have shown that
E. coli
meningitis follows a high degree of bacteremia and invasion of the blood-brain barrier.
E. coli
invasion of the blood-brain barrier, the essential step in the development of
E. coli
meningitis, requires specific microbial and host factors as well as microbe- and host-specific signaling molecules. Blockade of such microbial and host factors contributing to
E. coli
invasion of the blood-brain barrier is shown to be efficient in preventing
E. coli
penetration into the brain. The basis for requiring a high degree of bacteremia for
E. coli
penetration of the blood-brain barrier, however, remains unclear. Continued investigation on the microbial and host factors contributing to a high degree of bacteremia and
E. coli
invasion of the blood-brain barrier is likely to identify new targets for prevention and therapy of
E. coli
meningitis.
Publisher
American Society for Microbiology
Cited by
58 articles.
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