The Detection of <i>Streptococcus suis</i> Bacteremia Among Meningitis Patients with Sudden Deafness at a Tertiary Hospital

The increasing incidence of Streptococcus suis (S. suis)-associated meningitis, which is significantly associated with sudden deafness, necessitates further investigation into its clinical characteristics and outcomes. To evaluate the clinical features and outcomes of S. suis-associated meningitis in a tertiary hospital in Bali, Indonesia, this cross-sectional study reviewed the medical records of patients diagnosed with suspected S. suis-associated meningitis from 2022 to 2024. The diagnosis of meningitis was based on the presence of fever, headache, neck stiffness, and altered mental status. Blood cultures were performed to confirm S. suis-associated meningitis. The diagnosis was confirmed when a blood culture was positive for S. suis and was probable based on a history of consuming raw pork. Both cases were categorized as S. suis-associated meningitis. Out of 67 patients, 34 (50.7%) presented with deafness. Common symptoms of meningitis include fever (100%), neck stiffness (100%), and severe headache (28.4%). Blood cultures revealed S. suis in 10.5% of cases. The total number of S. suis-associated meningitis cases was 31 out of 67 (46.3%), comprising probable cases (30, 44.8%) and confirmed cases (7, 10.4%). S. suis bacteremia caused deafness in 85.7% of cases. This study found no significant association between raw pork consumption and deafness (p = 0.151; odds ratio = 1.538, 95% CI = 0.584-4.055). The overall case fatality rate was 4.5%, with a 1.5% mortality rate among patients with confirmed S. suis-associated meningitis. The most common complications noted in this study were septic shock and sudden deafness. Increased awareness and preventive measures regarding pig-related exposure are crucial for managing this emerging public health threat.