Department of Neurology, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany.
Expert Rev Anti Infect Ther. 2011 Nov;9(11):1053-65. doi: 10.1586/eri.11.129.
Despite targeted therapy, case-fatality rates and neurologic sequelae of bacterial meningitis remain unacceptably high. The poor outcome is mainly due to secondary systemic and intracranial complications. These complications seem to be both a consequence of the inflammatory response to the invading pathogen and release of bacterial components by the pathogen itself. Therefore, within the last decades, research has focused on the mechanism underlying immune regulation and the inhibition of bacterial lysis in order to identify new targets for adjuvant therapy. The scope of this article is to give an overview on current treatment strategies of bacterial meningitis, to summarize new insights on the pathophysiology of bacterial meningitis, and to give an outlook on new treatment strategies derived from experimental models.
尽管有靶向治疗,但细菌性脑膜炎的病死率和神经后遗症仍高得令人无法接受。不良预后主要是由于继发的全身和颅内并发症。这些并发症似乎既是对入侵病原体的炎症反应的结果,也是病原体本身释放细菌成分的结果。因此,在过去几十年中,研究的重点是免疫调节机制和抑制细菌裂解的机制,以确定辅助治疗的新靶点。本文的范围是概述细菌性脑膜炎的当前治疗策略,总结细菌性脑膜炎病理生理学的新见解,并展望从实验模型中得出的新治疗策略。