Hanife Nur Karakoc Parlayan, Asli Haykir Solay, Begum Ruveyda Aksoy, Dilek Bulut, Mahsa Hojabri, Irfan Sencan
{"title":"Clinical Insights and Outcomes in Community-Acquired Acute Bacterial Meningitis <em>versus</em> Postoperative Bacterial Meningitis.","authors":"Hanife Nur Karakoc Parlayan, Asli Haykir Solay, Begum Ruveyda Aksoy, Dilek Bulut, Mahsa Hojabri, Irfan Sencan","doi":"10.29271/jcpsp.2024.12.1441","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the demographics, clinical characteristics, and in-hospital mortality rates between community-acquired bacterial meningitis cases and postoperative bacterial meningitis.</p><p><strong>Study design: </strong>Analytical study. Place and Duration of the Study: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from 2016 to 2022.</p><p><strong>Methodology: </strong>A total of 153 patients diagnosed with bacterial meningitis were included and categorised into two groups: 95 (62.1%) with community-acquired bacterial meningitis (CABM) and 58 (37.9%) with postoperative bacterial meningitis (POBM). Demographics, clinical features, laboratory, paraclinical findings, treatments, and outcomes of the cases were compared. Data were retrieved using a standard data collection form from the electronic medical records.</p><p><strong>Results: </strong>A substantial portion (58.8%) of all patients had comorbidities. Fever was the common symptom in all groups. Headache, neck stiffness, nausea, and vomiting were more often observed in the CABM group (p <0.001). Upon admission, the CABM exhibited higher levels of white blood cell count, C-reactive protein, and procalcitonin (p = 0.017, p = 0.004, p = 0.007, respectively). Overall 33.1% had positive cerebrospinal fluid cultures. The overall mortality rate was 26.8%. POBM was associated with longer hospital and intensive care unit (ICU) stays (p <0.001). Shorter treatment durations, lower Glasgow coma scale scores (GCS), higher Charlson Comorbidity Index values, and elevated markers of inflammation were related to mortality.</p><p><strong>Conclusion: </strong>This study illuminates the differences in clinical presentations and outcomes between community-acquired and postoperative bacterial meningitis. It also suggests that factors such as lower GCS scores, comorbidities, and elevated inflammation markers at the last follow-up may be associated with unfavourable clinical outcomes in bacterial meningitis.</p><p><strong>Key words: </strong>Postoperative meningitis, Central nervous system infection, Cerebrospinal fluid, Antibiotics.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1441-1447"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.29271/jcpsp.2024.12.1441","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To compare the demographics, clinical characteristics, and in-hospital mortality rates between community-acquired bacterial meningitis cases and postoperative bacterial meningitis.
Study design: Analytical study. Place and Duration of the Study: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from 2016 to 2022.
Methodology: A total of 153 patients diagnosed with bacterial meningitis were included and categorised into two groups: 95 (62.1%) with community-acquired bacterial meningitis (CABM) and 58 (37.9%) with postoperative bacterial meningitis (POBM). Demographics, clinical features, laboratory, paraclinical findings, treatments, and outcomes of the cases were compared. Data were retrieved using a standard data collection form from the electronic medical records.
Results: A substantial portion (58.8%) of all patients had comorbidities. Fever was the common symptom in all groups. Headache, neck stiffness, nausea, and vomiting were more often observed in the CABM group (p <0.001). Upon admission, the CABM exhibited higher levels of white blood cell count, C-reactive protein, and procalcitonin (p = 0.017, p = 0.004, p = 0.007, respectively). Overall 33.1% had positive cerebrospinal fluid cultures. The overall mortality rate was 26.8%. POBM was associated with longer hospital and intensive care unit (ICU) stays (p <0.001). Shorter treatment durations, lower Glasgow coma scale scores (GCS), higher Charlson Comorbidity Index values, and elevated markers of inflammation were related to mortality.
Conclusion: This study illuminates the differences in clinical presentations and outcomes between community-acquired and postoperative bacterial meningitis. It also suggests that factors such as lower GCS scores, comorbidities, and elevated inflammation markers at the last follow-up may be associated with unfavourable clinical outcomes in bacterial meningitis.
Key words: Postoperative meningitis, Central nervous system infection, Cerebrospinal fluid, Antibiotics.