阈值偏移：人工耳蜗植入对肺炎球菌性脑膜炎风险的影响。
Threshold shift: effects of cochlear implantation on the risk of pneumococcal meningitis.
作者信息
Wei Benjamin P C, Shepherd Robert K, Robins-Browne Roy M, Clark Graeme M, O'Leary Stephen J
机构信息
Bionic Ear Institute, the University of Melbourne, Melbourne, Victoria, Australia.
出版信息
Otolaryngol Head Neck Surg. 2007 Apr;136(4):589-96. doi: 10.1016/j.otohns.2006.11.039.
OBJECTIVES
The study goals were to examine whether cochlear implantation increases the risk of meningitis in the absence of other risk factors and to understand the pathogenesis of pneumococcal meningitis post cochlear implantation.
STUDY DESIGN AND SETTING
Four weeks following surgery, 54 rats (18 of which received a cochleostomy alone, 18 of which received a cochleostomy and acute cochlear implantation using standard surgical techniques, and 18 of which received a cochlear implant) were infected with Streptococcus pneumoniae via three different routes of bacterial inoculation (middle ear, inner ear, and intraperitoneal) to represent all potential routes of bacterial infection from the upper respiratory tract to the meninges.
RESULTS
The presence of a cochlear implant reduced the threshold of bacteria required to cause pneumococcal meningitis from all routes of infection in healthy animals.
CONCLUSION
The presence of a cochlear implant increases the risk of pneumococcal meningitis regardless of the route of bacterial infection.
SIGNIFICANCE
Early detection and treatment of pneumococcal infection such as otitis media may be required, as cochlear implantation may lead to a reduction of infectious threshold for meningitis.
目的
本研究的目标是检查在没有其他风险因素的情况下，人工耳蜗植入是否会增加患脑膜炎的风险，并了解人工耳蜗植入后肺炎球菌性脑膜炎的发病机制。
研究设计与设置
术后四周，54只大鼠（其中18只仅接受了耳蜗造孔术，18只接受了耳蜗造孔术并使用标准手术技术进行了急性人工耳蜗植入，18只接受了人工耳蜗植入）通过三种不同的细菌接种途径（中耳、内耳和腹腔内）感染肺炎链球菌，以代表从呼吸道到脑膜的所有潜在细菌感染途径。
结果
在健康动物中，人工耳蜗的存在降低了所有感染途径导致肺炎球菌性脑膜炎所需的细菌阈值。
结论
无论细菌感染途径如何，人工耳蜗的存在都会增加肺炎球菌性脑膜炎的风险。
意义
由于人工耳蜗植入可能会降低脑膜炎的感染阈值，可能需要对肺炎球菌感染如中耳炎进行早期检测和治疗。
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