Clinical Insights and Outcomes in Community-Acquired Acute Bacterial Meningitis versus Postoperative Bacterial Meningitis.

Hanife Nur Karakoc Parlayan, Asli Haykir Solay, Begum Ruveyda Aksoy, Dilek Bulut, Mahsa Hojabri, Irfan Sencan
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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.

社区获得性急性细菌性脑膜炎与术后细菌性脑膜炎的临床观察和结果。
目的:比较社区获得性细菌性脑膜炎病例和术后细菌性脑膜炎病例的人口统计学、临床特征和住院死亡率。研究设计:分析性研究。研究地点和时间:2016年至2022年,土耳其安卡拉Diskapi Yildirim Beyazit培训和研究医院传染病和临床微生物科。方法:共纳入153例诊断为细菌性脑膜炎的患者,并将其分为两组:95例(62.1%)为社区获得性细菌性脑膜炎(CABM), 58例(37.9%)为术后细菌性脑膜炎(POBM)。比较病例的人口统计学、临床特征、实验室、临床旁发现、治疗和结局。使用标准数据收集表格从电子病历中检索数据。结果:大部分(58.8%)患者有合并症。发热是所有组的共同症状。CABM组更常出现头痛、颈部僵硬、恶心和呕吐(结论:本研究阐明了社区获得性脑膜炎和术后细菌性脑膜炎的临床表现和预后差异。研究还表明,GCS评分较低、合并症和最后随访时炎症标志物升高等因素可能与细菌性脑膜炎的不利临床结果有关。关键词:术后脑膜炎,中枢神经系统感染,脑脊液,抗生素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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