Document Detail


Staphylococcus aureus meningitis: experience with cefuroxime treatment during a 16 year period in a Danish region.
MedLine Citation:
PMID:  12875516     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Staphylococcus aureus is a rare cause of bacterial meningitis and there is no consensus on antibiotic treatment. Nafcillin is a common choice in countries where it is approved and marketed. High-dose cefuroxime has been the systemic treatment used in the study region, and a retrospective record review was conducted to determine its clinical efficacy. Cases of bacterial meningitis during 1984-1999 in the County of North Jutland, Denmark (approx. 490000 inhabitants), were identified in a regional bacteriology register. Inclusion of a case required either growth of S. aureus from > or = 2 specimens of cerebrospinal fluid (CSF), 1 positive CSF specimen with a CSF leucocyte count > 10(8)/l or 1 positive CSF specimen with a concurrent positive blood culture. A diagnosis of brain abscess required growth of S. aureus from aspirated pus. Staphylococcus aureus meningitis was confirmed in 45 patients, and 5 additional patients had a brain abscess. 44 cases were nosocomial (mortality 16%) and 6 were community acquired (mortality 83%). None of the isolates was methicillin resistant and 6 were penicillin susceptible. Intraventricular antibiotic treatment was given to 28 patients, systemic therapy included cefuroxime in 32 patients (64%) as either a primary or secondary choice, 6 (12%) were treated with penicillin G, 10 (20%) with penicillinase-resistant penicillin and 2 (4%) with cephalothin. Among 31 nosocomial cases treated systemically with cefuroxime the mortality was 10% (95% exact confidence limits 2-26%). In conclusion, cefuroxime seems to be a valid choice for S. aureus meningitis in the nosocomial setting.
Authors:
Mette Nørgaard; Gudrun Gudmundsdottir; Carsten Schade Larsen; Henrik Carl Schønheyder
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of infectious diseases     Volume:  35     ISSN:  0036-5548     ISO Abbreviation:  Scand. J. Infect. Dis.     Publication Date:  2003  
Date Detail:
Created Date:  2003-07-23     Completed Date:  2003-09-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0215333     Medline TA:  Scand J Infect Dis     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  311-4     Citation Subset:  IM    
Affiliation:
Department of Medical Haematology, Aalborg Hospital, Aalborg, Denmark. m.noergaard@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cefuroxime / administration & dosage*
Child
Child, Preschool
Cross Infection / diagnosis,  drug therapy,  epidemiology
Denmark / epidemiology
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Infant
Male
Meningitis, Bacterial / diagnosis,  drug therapy*,  epidemiology
Middle Aged
Retrospective Studies
Staphylococcal Infections / diagnosis,  drug therapy*,  epidemiology
Staphylococcus aureus / drug effects,  isolation & purification*
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
55268-75-2/Cefuroxime

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


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