Summary MeninGene and SMS study

Background

Bacterial meningitis is an inflammation of the meninges that, despite prompt treatment, leads to death or severe residual effects in a significant number of patients. The bacteria causing meningitis commonly reside in the nose or pharynx of many healthy individuals. The reasons why these bacteria cause meningitis in certain people are still not fully understood. Read more about about the background of bacterial meningitis and our translational research here.

Objective of the Study

The MeninGene study, initiated in 2006, aims to identify genetic factors contributing to susceptibility to bacterial meningitis and unfavorable disease progression. To improve the prognosis of bacterial meningitis, new adjunctive therapies are needed. Studies on genetic factors can provide insights into mechanisms contributing to adverse outcomes of the disease and may lead to new treatment strategies.

The Serial Meningitis Sampling (SMS) study, initiated in 2014, is a sub-study within MeninGene. The aim of the SMS sub-study is to establish a biobank of patient materials for future research into bacterial meningitis. This will allow determination of the functional significance of genetic variations identified in MeninGene that may influence susceptibility to meningitis and disease severity. The study also aims to assess the expression of risk genes and their impact on inflammatory and coagulation factors in patients with bacterial meningitis.

Study Design

In the Netherlands, all positive cerebrospinal fluid cultures are sent to the Dutch Reference Laboratory for Bacterial Meningitis, a collaboration between RIVM and Amsterdam UMC. MeninGene researchers receive anonymous notifications from the reference laboratory regarding patients hospitalized with bacterial meningitis in the Netherlands. Subsequently, they contact the treating neurologist/specialist to inquire about including these patients in the study. Physicians may also directly contact the researchers to enroll a patient.

After obtaining consent from a patient to participate in the study, blood is drawn for DNA analysis. The DNA is examined to determine if certain variations are more prevalent among individuals with bacterial meningitis compared to DNA from healthy individuals (control group). The study also investigates the DNA of the meningitis-causing pathogens. The control group consists of partners of patients or unrelated household members who have been exposed to similar environmental factors. Disease progression is tracked in a database using admission data, including physical examinations, blood tests, and CT scans. If cerebrospinal fluid remains from the diagnostic lumbar puncture, it is stored at -80°C (or as cold as possible).

In the SMS study, 250 patients with bacterial meningitis who have already been included in the MeninGene study are prospectively enrolled. Serial blood samples are taken from these patients on days 0, 1, 2, and 7 of hospitalization, and again 3 months post-discharge.

Participating Centers

All hospitals in the Netherlands participate in the MeninGene study, coordinated through the neurology department.

The SMS sub-study involves 13 hospitals:

• Amsterdam UMC, location AMC
• OLVG, location West
• Spaarne Gasthuis, location Haarlem
• Noordwest Ziekenhuisgroep, location Alkmaar
• Haaglanden Medisch Centrum
• Haga Ziekenhuis
• Isala

• Rijnstate ziekenhuis
• Leids Universiteit Medisch Centrum
• Albert Schweitzer ziekenhuis
• Radboud UMC
• Ziekenhuisgroep Twente 
• Zuyderland Medisch Centrum

Does participating involve risks?

Participation in the research means that 14 ml of blood will be collected from the patient and individuals in the control group for DNA analysis. Additionally, for the SMS sub-study, five extra blood collections will follow. All blood samples from the patient will, if possible, be taken simultaneously with scheduled blood draws as part of regular patient care. There are no further risks associated with these studies.

Contact research team

Principal investigators: prof. dr. D. van de Beek (neurologist), prof. dr. M. C. Brouwer (neuroloog)
Coördinators:                   drs. E. Drost (physician-researcher), drs. E. Schepers (physician-researcher)

If you have a patient who could be included in the (SMS) MeninGene study or if you are unsure about eligibility, please feel free to contact us: