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Eur J Clin Microbiol Infect Dis ; 37(4): 755-763, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29353379

RESUMO

The epidemiology of healthcare-associated meningitis (HAM) is dominated by commensal bacteria from the skin, as coagulase-negative staphylococci (CoNS). We hypothesized that the pauci-symptomatic and mild inflammatory patterns of HAM are related to the low pathogenic state of CoNS. Our aim was to describe clinical and biological features of CoNS HAM, compared to other HAM. All consecutive patients with HAM admitted in our hospital were retrospectively included from 2007 to 2014. HAM due to CoNS were compared to HAM caused by other bacteria (controls) for clinical and laboratory patterns. Seventy-one cases of HAM were included, comprising 18 CoNS and 53 controls. Patients were not different in terms of baseline characteristics. CoNS HAM occurred later after the last surgery than controls (17 vs. 12 days, p = 0.029) and had higher Glasgow Coma Scale (GCS) score (14 vs. 13, p = 0.038). Cerebrospinal fluid (CSF) analysis revealed a lower pleocytosis (25 vs. 1340/mm3, p < 0.001), a higher glucose level (3.75 vs. 0.8 mmol/L, p < 0.001), and a lower protein level (744 vs. 1751 mg/L, p < 0.001) in the CoNS group than in the control group, respectively. HAM due to CoNS was significantly less symptomatic and less inflammatory than HAM due to other bacteria.


Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Meningites Bacterianas/epidemiologia , Meningites Bacterianas/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adulto , Técnicas Bacteriológicas , Líquido Cefalorraquidiano/citologia , Líquido Cefalorraquidiano/microbiologia , Coagulase , Infecção Hospitalar/líquido cefalorraquidiano , Feminino , Escala de Coma de Glasgow , Humanos , Estimativa de Kaplan-Meier , Leucocitose , Masculino , Meningites Bacterianas/líquido cefalorraquidiano , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções Estafilocócicas/líquido cefalorraquidiano , Staphylococcus , Resultado do Tratamento
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