A hospital-based study on etiology and prognosis of bacterial meningitis in adults

Abstract Bacterial meningitis is a neurological emergency with high morbidity and mortality. We herein investigated clinical features, etiology, antimicrobial susceptibility profiles, and prognosis of bacterial meningitis in adults from a single tertiary center. We retrospectively reviewed medical r...

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Autores principales:	Jun-Sang Sunwoo, Hye-Rim Shin, Han Sang Lee, Jangsup Moon, Soon-Tae Lee, Keun-Hwa Jung, Kyung-Il Park, Ki-Young Jung, Manho Kim, Sang Kun Lee, Kon Chu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bb3fecb1415649a3885730c2445e6504
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spelling	oai:doaj.org-article:bb3fecb1415649a3885730c2445e65042021-12-02T16:30:57ZA hospital-based study on etiology and prognosis of bacterial meningitis in adults10.1038/s41598-021-85382-42045-2322https://doaj.org/article/bb3fecb1415649a3885730c2445e65042021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85382-4https://doaj.org/toc/2045-2322Abstract Bacterial meningitis is a neurological emergency with high morbidity and mortality. We herein investigated clinical features, etiology, antimicrobial susceptibility profiles, and prognosis of bacterial meningitis in adults from a single tertiary center. We retrospectively reviewed medical records of patients with laboratory-confirmed bacterial meningitis from 2007 to 2016. Patients with recent neurosurgery, head trauma, or indwelling neurosurgical devices were classified as having healthcare-related meningitis. Causative microorganisms were identified by analyzing cerebrospinal fluid (CSF) and blood cultures, and antimicrobial susceptibility profiles were evaluated. We performed multiple logistic regression analysis to identify factors associated with unfavorable outcomes. We identified 161 cases (age, 55.9 ± 15.5 years; male, 50.9%), of which 43 had community-acquired and 118 had healthcare-related meningitis. CSF and blood culture positivity rates were 91.3% and 30.4%, respectively. In community-acquired meningitis patients, Klebsiella pneumoniae (25.6%) was the most common isolate, followed by Streptococcus pneumoniae (18.6%) and Listeria monocytogenes (11.6%). The susceptibility rates of K. pneumoniae to ceftriaxone, cefepime, and meropenem were 85.7%, 81.3%, and 100%, respectively. Among healthcare-related meningitis patients, the most common bacterial isolates were coagulase-negative staphylococci (28.0%), followed by Staphylococcus aureus (16.1%) and Enterobacter spp. (13.6%). Neurological complications occurred in 39.1% of the patients and the 3-month mortality rate was 14.8%. After adjusting for covariates, unfavorable outcome was significantly associated with old age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00–1.06), neurological complications (OR 4.53, 95% CI 1.57–13.05), and initial Glasgow coma scale ≤ 8 (OR 19.71, 95% CI 4.35–89.40). Understanding bacterial pathogens and their antibiotic susceptibility may help optimize antimicrobial therapy in adult bacterial meningitis.Jun-Sang SunwooHye-Rim ShinHan Sang LeeJangsup MoonSoon-Tae LeeKeun-Hwa JungKyung-Il ParkKi-Young JungManho KimSang Kun LeeKon ChuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jun-Sang Sunwoo Hye-Rim Shin Han Sang Lee Jangsup Moon Soon-Tae Lee Keun-Hwa Jung Kyung-Il Park Ki-Young Jung Manho Kim Sang Kun Lee Kon Chu A hospital-based study on etiology and prognosis of bacterial meningitis in adults
description	Abstract Bacterial meningitis is a neurological emergency with high morbidity and mortality. We herein investigated clinical features, etiology, antimicrobial susceptibility profiles, and prognosis of bacterial meningitis in adults from a single tertiary center. We retrospectively reviewed medical records of patients with laboratory-confirmed bacterial meningitis from 2007 to 2016. Patients with recent neurosurgery, head trauma, or indwelling neurosurgical devices were classified as having healthcare-related meningitis. Causative microorganisms were identified by analyzing cerebrospinal fluid (CSF) and blood cultures, and antimicrobial susceptibility profiles were evaluated. We performed multiple logistic regression analysis to identify factors associated with unfavorable outcomes. We identified 161 cases (age, 55.9 ± 15.5 years; male, 50.9%), of which 43 had community-acquired and 118 had healthcare-related meningitis. CSF and blood culture positivity rates were 91.3% and 30.4%, respectively. In community-acquired meningitis patients, Klebsiella pneumoniae (25.6%) was the most common isolate, followed by Streptococcus pneumoniae (18.6%) and Listeria monocytogenes (11.6%). The susceptibility rates of K. pneumoniae to ceftriaxone, cefepime, and meropenem were 85.7%, 81.3%, and 100%, respectively. Among healthcare-related meningitis patients, the most common bacterial isolates were coagulase-negative staphylococci (28.0%), followed by Staphylococcus aureus (16.1%) and Enterobacter spp. (13.6%). Neurological complications occurred in 39.1% of the patients and the 3-month mortality rate was 14.8%. After adjusting for covariates, unfavorable outcome was significantly associated with old age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00–1.06), neurological complications (OR 4.53, 95% CI 1.57–13.05), and initial Glasgow coma scale ≤ 8 (OR 19.71, 95% CI 4.35–89.40). Understanding bacterial pathogens and their antibiotic susceptibility may help optimize antimicrobial therapy in adult bacterial meningitis.
format	article
author	Jun-Sang Sunwoo Hye-Rim Shin Han Sang Lee Jangsup Moon Soon-Tae Lee Keun-Hwa Jung Kyung-Il Park Ki-Young Jung Manho Kim Sang Kun Lee Kon Chu
author_facet	Jun-Sang Sunwoo Hye-Rim Shin Han Sang Lee Jangsup Moon Soon-Tae Lee Keun-Hwa Jung Kyung-Il Park Ki-Young Jung Manho Kim Sang Kun Lee Kon Chu
author_sort	Jun-Sang Sunwoo
title	A hospital-based study on etiology and prognosis of bacterial meningitis in adults
title_short	A hospital-based study on etiology and prognosis of bacterial meningitis in adults
title_full	A hospital-based study on etiology and prognosis of bacterial meningitis in adults
title_fullStr	A hospital-based study on etiology and prognosis of bacterial meningitis in adults
title_full_unstemmed	A hospital-based study on etiology and prognosis of bacterial meningitis in adults
title_sort	hospital-based study on etiology and prognosis of bacterial meningitis in adults
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/bb3fecb1415649a3885730c2445e6504
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A hospital-based study on etiology and prognosis of bacterial meningitis in adults

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