Eti ology and Epidemi ology of Bacterial Meningitis in Adults

Česká verzia

Authors: O. Džupová ¹; S. Polívková ¹; D. Smíšková ²; A. Gabrielová ³; J. Beneš ¹
Authors place of work: FN Na Bulovce, Praha Univerzita Karlova, 3. lékařská fakulta, II. infekční klinika, 2Univerzita Karlova, 2. lékařská fakulta, I. infekční klinika, 3Oddělení klinické mikrobiologie ¹
Published in the journal: Cesk Slov Neurol N 2009; 72/105(4): 331-335
Category: Original Paper

Summary

Objectives:
The aim of the presented part of study was to describe epidemi ological characteristics of adult bacteri al meningitis and detect the prognostic significance of selected pathogens for the risk of fatal o utcome and sequelae. Materi al and methods: Prospective observati onal longitudinal study of adult pati ents tre ated for bacteri al meningitis at a speci alized unit. Anamnestic, clinical and laboratory data, complicati ons and o utcomes were recorded. Eti ological agent was identifi ed in the cerebrospinal fluid and blo od by me ans of culture, polymerase chain re acti on and latexagglutinati on. Results: From 1997– 2006, 296 adult pati ents (128 women, 168 men) with acute bacteri al meningitis, age range 16– 85 ye ars and medi an age 51 ye ars, were hospitalized. The most frequent pathogens were Streptococcus pne umoni ae in 27.7% and Neisseri a meningitidis in 25.4% of pati ents. Listeri a monocytogenes was the pathogen in 7.1%, staphylococci in 6.1% and gramnegative rods in 5.4% of pati ents. Eti ology was not identifi ed in 24% of pati ents. Pne umococci and gramnegative rods carri ed the highest case fatality rati o. Fifty- nine pati ents di ed (20%) and 54 pati ents (18%) survived with permanent sequelae. Gramnegative rods proved to be a predictor of risk of de ath and meningococci were conversely predictor of low risk of de ath. Multivari ant analysis did not confirm any pathogen as predictive for risk of sequelae; meningococci and unidentifi ed eti ology were associ ated with less sequelae. Conclusi on: Bacteri al meningitis remains to carry significant morbidity and case fatality rati o. S. pne umoni ae and N. meningitidis were the most frequent pathogens in the current study altho ugh many other bacteri al speci es were identifi ed. It is advisable to incre ase the eti ology identificati on rate by me ans of rigoro us sending of cerebrospinal fluid and blo od for culture and enhanced availability of molecular di agnostic techniques for detecti on of all potenti al agents of meningitis.

Key words:
bacterial meningitis – etiological agent – fatal outcome – sequelae

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