Meningitis-associated Escherichia coli

E. coli is the most common Gram-negative organism causing neonatal meningitis and neonatal meningitis continues to be an important cause of mortality and morbidity throughout the world. Our incomplete knowledge of its pathogenesis and pathophysiology contributes to such mortality and morbidity. Recent reports of neonatal meningitis caused by E. coli strains producing CTX-M-type or TEM-type extended-spectrum β-lactamases create a challenge. E. coli invasion of the blood-brain barrier is a prerequisite for penetration into the brain, and requires specific microbial-host factors as well as microbe- and host-specific signaling molecules. Blockade of such microbial-host factors and host cell signaling molecules is shown to be efficient in preventing E. coli penetration into the brain, the essential step in the development of E. coli meningitis. Continued investigation of the microbial and host factors contributing to E. coli invasion of the blood-brain barrier is likely to identify new targets for prevention and therapy of E. coli meningitis, thereby limiting the exposure to emerging antimicrobial-resistant E. coli.