The clinical characteristics of spontaneous Gram-negative bacterial meningitis in adults: A hospital-based study.

Authors:
Chia-Yi Lien
Chia-Yi Lien
Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine
Taiwan
Wan-Chen Tsai
Wan-Chen Tsai
Taipei Veterans General Hospital
Taiwan
Shih-Ying Chen
Shih-Ying Chen
Chia Nan University of Pharmacy and Science
Taiwan
Chi-Ren Huang
Chi-Ren Huang
Chang Gung University College of Medicine
Taiwan
Chun-Chih Chien
Chun-Chih Chien
Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine
Taiwan
Cheng-Hsien Lu
Cheng-Hsien Lu
Chang Gung University College of Medicine
Taiwan
Wen-Neng Chang
Wen-Neng Chang
Chang Gung University College of Medicine
Taiwan

J Clin Neurosci 2019 Jun 17;64:101-105. Epub 2019 Apr 17.

Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address:

The epidemiologic trend of acute bacterial meningitis can change more dramatically than any other bacterial disease, and a decrease in spontaneous adult bacterial meningitis (ABM) has been noted in serial studies of the epidemiologic trend of ABM in Taiwan. The purpose of this study was to analyze the clinical characteristics, laboratory data and therapeutic outcomes of 149 patients with spontaneous Gram-negative (G(-)) ABM collected during a study period of 31 years (1986-2016). The 149 patients included 107 men and 42 women, aged 18-86 years. The common underlying conditions were diabetes mellitus, liver cirrhosis and alcoholism, and the leading clinical presentations were fever, altered consciousness and septic shock. Compared the clinical characteristics of the patients identified in the study period of 2001-2106 to the patients identified in the study period of 1986-2000, the former group of patients had a significantly higher incidence of systemic malignance. In the recent 16 years (2001-2016), Klebsiella pneumoniae, Pseudomonas spp. and Escherichia coli were the leading three implicated bacterial pathogens of spontaneous G(-) ABM, accounting for 61.3% (38/62), 11.3% (7/62) and 11.3% (7/62%) of all cases, respectively. The overall mortality rate from spontaneous G(-) ABM was high (47.0%, 70/149) and the presence of septic shock and lower cerebrospinal fluid glucose level were significant prognostic factors. Because of the decreasing incidence of spontaneous ABM in Taiwan, close examination of this specific infectious syndrome is important in order to monitor the epidemiologic trend and improve the therapeutic strategy.

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Source
http://dx.doi.org/10.1016/j.jocn.2019.03.047DOI Listing
June 2019

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