The Causes and Treatment Outcomes of 91 Patients with Adult Nosocomial Meningitis
The Korean Journal of Internal Medicine
; : 171-179, 2012.
Article
em En
| WPRIM
| ID: wpr-28114
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND/AIMS: Frequent pathogens of nosocomial meningitis were investigated and the adequacy of empiric antibiotic therapy was assessed. Outcomes of nosocomial meningitis were also evaluated. METHODS: Ninety-one patients, who were diagnosed and treated for nosocomial meningitis at a single tertiary hospital in Daegu, Korea for 10 years, were included. Medical record and electronic laboratory data on the causative pathogens, antibiotics used, and outcomes were retrospectively investigated. RESULTS: Coagulase-negative Staphylococcus (40.9%) was the most common pathogen, followed by Acinetobacter (32.5%). Both were cultured as a single organism in cerebrospinal fluid (CSF). Seventy-eight patients (85.7%) had infections related to external ventricular drains (EVD). The most common empirical antibiotics were extended-spectrum beta-lactam antibiotics plus vancomycin (35/91, 38.6%). Of the 27 patients who had cultured Acinetobacter in CSF, 10 (37%) were given the wrong empirical antibiotic treatment. Seven of the 27 patients (26.9%) with cultured Acinetobacter died, and overall mortality of the 91 patients was 16.5%. In the multivariate analysis, the presence of combined septic shock (p < 0.001) and a persistent EVD state (p = 0.021) were associated with a poor prognosis. CONCLUSIONS: Acinetobacter is one of the leading pathogens of nosocomial meningitis and may lead to inadequate coverage of empiric antibiotic therapy due to increasing resistance. An EVD should be removed early in cases of suspected nosocomial meningitis, and carbapenem might be required for the poor treatment response.
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Índice:
WPRIM
Assunto principal:
Infecções Estafilocócicas
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Staphylococcus
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Fatores de Tempo
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Acinetobacter
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Infecções por Acinetobacter
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Modelos Logísticos
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Razão de Chances
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Líquido Cefalorraquidiano
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Infecção Hospitalar
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Análise Multivariada
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
The Korean Journal of Internal Medicine
Ano de publicação:
2012
Tipo de documento:
Article