Document Detail


Acute bacterial meningitis in adults. A 12-year review.
MedLine Citation:
PMID:  11144034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
One hundred three episodes of acute bacterial meningitis in adults hospitalized in Edmonton's 2 largest hospitals from 1985 to 1996 were reviewed. Cases complicating neurosurgery were excluded. Most cases were community-acquired (87%). Twenty-three cases remained culture-negative, and there was no statistical relation between culture negativity and antibiotic pretreatment. Streptococcus pneumoniae was the predominant pathogen (52.5%), but Listeria monocytogenes was the second most common isolate, accounting for 12.5% of culture-positive cases. Compared to non-listerial meningitis, those with listeriosis were more likely to have negative cerebrospinal fluid (CSF) Gram stains (p = 0.07), CSF leukocyte counts < 1,000 cells/mm3 (p < 0.003), and normal CSF glucose (p = 0.006). Bacterial antigen detection was found to be of low sensitivity: 33% in all patients, but only 9% in cases with negative CSF Gram stains. The overall mortality was 18%, with 15 deaths directly attributable to acute meningitis; the case-fatality rates for S. pneumoniae and L. monocytogenes were 24% and 40%, respectively. Mortality was significantly higher among those with seizures (34% versus 7%, respectively; p < 0.001; OR = 17.6). Despite the urgency of acute bacterial meningitis, there were considerable delays in the institution of empiric antibiotics; mortality rates were slightly higher in those who experienced such a delay (16% versus 7% respectively; p = 0.18).
Authors:
A S Hussein; S D Shafran
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Medicine     Volume:  79     ISSN:  0025-7974     ISO Abbreviation:  Medicine (Baltimore)     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-19     Completed Date:  2001-01-04     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  2985248R     Medline TA:  Medicine (Baltimore)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  360-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Canada.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Alberta / epidemiology
Anti-Bacterial Agents / therapeutic use
Community-Acquired Infections / diagnosis,  drug therapy,  epidemiology*,  etiology
Cross Infection / diagnosis,  drug therapy,  epidemiology*,  etiology
Female
Hospitalization / statistics & numerical data
Humans
Immunocompromised Host
Incidence
Male
Meningitis, Bacterial / diagnosis,  drug therapy,  epidemiology*,  etiology
Middle Aged
Population Surveillance
Retrospective Studies
Sex Distribution
Splenectomy / adverse effects
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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