Evidence map›Paper›PMID 36251556›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Risk Factors for Severe Cutaneous Anthrax in a Retrospective Case Series and Use of a Clinical Algorithm to Identify Likely Meningitis and Evaluate Treatment Outcomes, Kyrgyz Republic, 2005-2012.

Ainura Kutmanova, Saparbai Zholdoshev, Katherine M Roguski, Melis Sholpanbay Uulu, Marissa K Person, Rachel Cook, Julia Bugrysheva, Patrick Nadol, Aisuluu Buranchieva, Lira Imanbaeva and 3 more

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Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.7field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Anthrax meningoencephalitis: A case report.Experimental and therapeutic medicine · 2025
    Article
  2. Article
  3. CDC Guidelines for the Prevention and Treatment of Anthrax, 2023.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2023
    Article
  4. Human Anthrax: Update of the Diagnosis and Treatment.Diagnostics (Basel, Switzerland) · 2023
    Review
  5. Responding to the Threat Posed by Anthrax: Updated Evidence to Improve Preparedness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Ainura KutmanovaDepartment of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic.ORCID 0000-0003-2611-6426
Saparbai ZholdoshevDepartment of Epidemiology, Microbiology with a course of Infectious Diseases, Osh State University, Osh, Kyrgyz Republic.
Katherine M RoguskiDivision of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Melis Sholpanbay UuluDepartment of Infectious Diseases, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic.
Marissa K PersonDivision of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Rachel CookDivision of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Julia BugryshevaDivision of Preparedness and Emerging Infections, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Patrick NadolCDC Kyrgyzstan, US Centers for Disease Control and Prevention, Bishkek, Kyrgyz Republic.
Aisuluu BuranchievaDepartment of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic.
Lira ImanbaevaDepartment of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic.
Ainura DzhangazievaDepartment of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic.
William A BowerDivision of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0001-6538-8665
Katherine HendricksDivision of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Centers for Disease Control and Prevention · USInternational Higher School of MedicineKyrgyz State Medical Academy · KGOsh State University · KG

Funding

CDC HHS
6 · The paper itself

Abstract

backgroundUS Centers for Disease Control and Prevention guidelines currently recommend triple-therapy antimicrobial treatment for anthrax meningitis. In the Kyrgyz Republic, a country with endemic anthrax, cutaneous anthrax patients are routinely hospitalized and treated successfully with only monotherapy or dual therapy. Clinical algorithms have been developed to identify patients with likely anthrax meningitis based on signs and symptoms alone. We sought to retrospectively identify likely meningitis patients in the Kyrgyz Republic using a clinical algorithm and evaluate risk factors and their outcomes by type of treatment.

methodsWe conducted a retrospective chart review of cutaneous anthrax patients in the Kyrgyz Republic from 2005 through 2012. Using previous methods, we developed a highly specific algorithm to categorize patients by meningitis status. We then evaluated patient risk factors, treatments, and outcomes by disease severity and meningitis status.

resultsWe categorized 37 of 230 cutaneous anthrax patients as likely having meningitis. All 37 likely meningitis patients survived, receiving only mono- or dual-therapy antimicrobials. We identified underlying medical conditions, such as obesity, hypertension, and chronic obstructive pulmonary disease, and tobacco and alcohol use, as potential risk factors for severe anthrax and anthrax meningitis.

conclusionsBased on our analyses, treatment of anthrax meningitis may not require 3 antimicrobials, which could impact future anthrax treatment recommendations. In addition, chronic comorbidities may increase risk for severe anthrax and anthrax meningitis. Future research should further investigate potential risk factors for severe anthrax and their impact on laboratory-confirmed meningitis and evaluate mono- and dual-therapy antimicrobial regimens for anthrax meningitis.

Indexed as

AnthraxAnti-Infective AgentsMeningitis, BacterialAlgorithmsAnti-Bacterial AgentsHumansKyrgyzstanRetrospective StudiesRisk FactorsSkin Diseases, BacterialTreatment OutcomeAnti-Bacterial AgentsAnti-Infective AgentsanthraxKyrgyz Republicmeningitistreatment

Identifiers

PMID36251556
PMCPMC9649429
OpenAlexW4306632868

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.