867. Upregulated Matrix Metalloproteinase-2 Relates to Milder Hearing Impairment in Bacterial Meningitis
Session: Oral Abstract Session: Pushing the Envelope in CNS Infections
Thursday, October 4, 2018: 2:45 PM
Room: S 158

Hearing impairment is a well-recognized sequela caused by bacterial meningitis, but the underlying pathophysiology remains largely unknown. Matrix metalloproteinase-2 (MMP-2) is known to affect neuronal cell damage and survival in different diseases of the brain. We investigated whether levels of MMP-2 in the cerebrospinal fluid (CSF) relate to the extent of hearing impairment in children with bacterial meningitis.


Clinical data of 179 children were obtained from a previous clinical trial examining the adjuvant treatment of bacterial meningitis in Latin America in 1996-2003. At discharge or shortly thereafter, the ability to hear was measured with brain stem evoked response audiometry or traditional pure tone audiometry. Levels of CSF MMP-2 on admission (CSF1, n=161) and 12-24 hours later (CSF2, n=133) were assessed by zymography. The combined results for the detected pro-form and active MMP-2 were compared with the audiological outcome of the patients.


MMP-2 was detected in half of both the CSF1 and CSF2 samples. The median densitometric values with interquartile ranges (IQRs) were 0.04 (IQR 0.00-0.29) for CSF1 and 0.00 (IQR 0.00-0.33) for CSF2. Detectable MMP-2 associated with milder hearing impairment in CSF1 (p = 0.05), but not in CSF2 (p = 0.1). Patients who were deaf at discharge had lower levels of MMP-2 in both samples (CSF1, p = 0.05; CSF2, p = 0.04), compared to patients who were not deaf. A MMP-2 level over the 75th percentile in CSF1 predicted lower odds of any audiological sequelae (odds ratio 0.30, 95% confidence interval 0.14-0.68, p = 0.004).


The upregulation of MMP-2 in the CSF associated with a better audiological outcome in children with bacterial meningitis. The results suggest that MMP-2 might play a protective role in the development of hearing sequelae due to bacterial meningitis.

Okko Savonius, MD1, Irmeli Roine, MD, PhD2, Saeed Alassiri, DDS3, Taina Tervahartiala, DDS, PhD3, Otto Helve, MD, PhD1, Josefina Fernandez, MD4, Heikki Peltola, MD, PhD, Professor1, Timo Sorsa, DDS, PhD3 and Tuula Pelkonen, MD, PhD1, (1)Children’s Hospital, Helsinki University Hospital, and the University of Helsinki, Helsinki, Finland, (2)Faculty of Medicine, University Diego Portales, Santiago, Chile, (3)Department of Oral and Maxillofacial Diseases, Institute of Dentistry, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland, (4)Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic


O. Savonius, None

I. Roine, None

S. Alassiri, None

T. Tervahartiala, None

O. Helve, None

J. Fernandez, None

H. Peltola, None

T. Sorsa, None

T. Pelkonen, None

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.