SMS substudy

Background

Genetic polymorphisms are major determinants of susceptibility and specific complications in bacterial meningitis patients. In 2006 we started a nationwide prospective genetic association study, which was continued in 2013 as the MeninGene study. Further characterisation of the functionality of genetic polymorphisms is needed to determine the nature of the influence on susceptibility and disease severity.

Objectives

1. To create a Biobank by collecting patient materials (blood samples and throat swabs) which can be used for future bacterial meningitis research.
2. To characterize the functionality of genetic polymorphisms influencing susceptibility and disease severity during the acute phase of bacterial meningitis.
3. To evaluate the expression of identified risk genes and the effect on inflammation and coagulation in bacterial meningitis patients.

Study design

Sub-study in a nationwide prospective genetic association study (MeninGene study).

Study population

We will prospectively enrol 150 patients admitted with bacterial meningitis included in the MeninGene study. Inclusion criteria will be: age>16 yr and suspected bacterial meningitis defined by CSF characteristics (a glucose level of less than 1.9 mmol/L, a ratio of CSF glucose to blood glucose of less than 0.23, a protein level of more than 0.220 g/L, or a white-cell count of more than 2,000 per mm3) or a positive CSF Gram stain.

Nature and extent of the burden

From all patients blood will be obtained at 5 time points: admission (day 0), day 1, day 2, day 7 and 3 months after discharge. Blood samples will be drawn from an intravenous catheter, which is placed in all bacterial meningitis patients as part of standard care. Furthermore, a throat swab will be obtained from the meningitis patient and a control person at the day of admission.