LITERATURE UPDATE


Bacterial meningitis: an important healthcare issue in focus


Meningitis B, caused by Neisseria meningitidis, erupted in the news recently after an outbreak among students in the south-east of England, resulting in significant morbidity and several deaths. Here, Pathology in Practice Science Editor Brian Nation looks at a selection of current research into the wider sphere of bacterial meningitis.


Bacterial Meningitis Bulaeva A, Derber C. Med Clin North Am. 2025 May; 109 (3): 587–99. doi: 10.1016/j. mcna.2024.12.012.


Community-acquired bacterial meningitis has a high fatality rate, and survivors may have significant long-term neurologic sequelae, despite appropriate antibiotics. Although cerebrospinal fluid cultures and/ or PCR testing are necessary to establish a definitive case of bacterial meningitis, antibiotic administration should never be delayed while waiting to obtain a lumbar puncture. Patients with suspected


bacterial meningitis should be started on empiric antibiotics and adjunctive dexamethasone within an hour of presentation, with subsequent regimens targeted toward the identified pathogen. Vaccines are an important tool to minimise the risk of bacterial meningitis, and use should be encouraged by adults at higher risk.


Bacterial meningitis is a significant catalyst for neuroinflammation Parthasarathy S, Tharumasivam SV, Chavaan A, Giridharan B, Sundaram A. Int Rev Neurobiol. 2025; 180: 369–96. doi: 10.1016/bs.irn.2025.03.010.


Bacterial meningitis is a severe infection that can lead to neuroinflammation, posing risks to the central nervous system (CNS). This inflammation, if uncontrolled, can cause long-term neurological damage, cognitive decline, and neuron injury. Management strategies include


telemedicine and remote monitoring, enabling continuous observation and timely adjustments in treatment. Early detection through biosensor technology


Tamma PD. Clin Infect Dis. 2025 Jun 4; 80 (5): 959–68. doi: 10.1093/cid/ciaf071.


Scanning electron micrograph (SEM) of a single Neisseria meningitidis cell (blue) with its adhesive pili (yellow).


is vital, offering healthcare providers insights for proactive intervention before critical issues arise. Nutritional support, particularly hydration, is also emphasised to strengthen immune response and potentially delay disease progression. The chapter highlights the


transformative potential of artificial intelligence (AI) and machine learning in disease management, from prognostic assessments to creating personalised treatment plans. By integrating AI-driven insights with advanced monitoring and preventive approaches, healthcare providers can mitigate the impact of bacterial meningitis, enhancing patient outcomes and recovery potential.


The Effectiveness of Newer Beta-Lactams for the Treatment of Antimicrobial- Resistant Gram-Negative Meningitis Hsu AJ, Chiotos K, Heil EL, Shields RK,


The treatment of Gram- negative bacterial infections exhibiting resistance to all traditional β-lactam and fluoroquinolone agents (ie difficult-to-treat resistance [DTR]) poses challenges due to the limited number of active antibiotic agents. Managing DTR Gram-negative infections becomes even more complex when present in the central nervous system due to concerns for insufficient concentrations of agents in the cerebrospinal fluid and brain parenchyma. Several newer β-lactam agents with activity against DTR Gram-negatives are available, including cefiderocol, ceftazidime-avibactam, ceftolozane-tazobactam, imipenem-cilastatin-


relebactam, meropenem-vaborbactam, and sulbactam-durlobactam. This article examines host and drug


factors that influence an antibiotic’s effectiveness for the treatment of bacterial meningitis. The preclinical and clinical data in support of, or against, each of the aforementioned agents for the treatment of bacterial meningitis are also reviewed.


Bacterial meningitis in adults: therapeutic challenges in the era of antibiotic resistance and the potential of bacteriophages and associated by products Dzięgiel M, Głodowicz Z, Jóźwiak A, Roztkowska W, Necel A, Piechowicz L. Front Cell Infect Microbiol. 2026 Feb 6; 16: 1755353. doi: 10.3389/fcimb.2026.1755353. eCollection 2026.


Bacterial resistance to antibiotics is April 2026 WWW.PATHOLOGYINPRACTICE.COM 51


Arthur Charles-Orszag CC BY-SA 4.0 Wikimedia Commons


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