Bacterial communityacquired determinants longterm outcome prognosis abstract objectives. Communityacquired bacterial meningitis in adults in the netherlands, 200614. Communityacquired bacterial meningitis in adults in the. All these cases were diagnosed on the basis of a compatible clinical picture and a positive cerebrospinal fluid csf culture or blood culture. Acute bacterial meningitis continues to be a potentially life threatening condition. Risk factors for communityacquired bacterial meningitis. Emerging multidrug resistance isolates of hospital. Pdf the aetiology of acute community acquired bacterial. To create and test a prognostic model for persons with communityacquired bacterial meningitis and to determine whether antibiotic timing influences clinical outcome. The existing heterogeneity in diagnostic workup and treatment strategies in bacterial meningitis was the incentive to develop. We evaluated incidence and characteristics of patients with cancer included in a nationwide prospective cohort study of adults with communityacquired meningitis performed in the. Pdf acute communityacquired bacterial meningitis in adults.
Community acquired bacterial meningitis causes substantial morbidity and mortality in adults. The absence of neck rigidity, kernigs sign and brudzinskis sign does not rule out acute bacterial meningitis. Symptoms suggestive of csf leakage include rhinorrhea and otorrhea, but csf leakage may also go unnoticed 9. The diagnosis of arthritis was based upon the judgment of the treating physician. Communityacquired bacterial meningitis cabm is a lifethreatening infection that can be complicated by neurological deficits among survivors.
Acute communityacquired bacterial meningitis in adults. During the period 19772006, 675 episodes in adults aged. Emerging multidrug resistance isolates of hospitalacquired. Arthritis in adults with communityacquired bacterial. Bacterial meningitis in older adults is a wellstudied and serious disease, but few studies have investigated the epidemiology and outcomes of community acquired meningitis in older adults. The purpose of this study is to find the antibiotic susceptibility pattern of the bacteria detected from hospital and community. Bacterial meningitis is a severe infection with substantial mortality and morbidity 1, 2. Pdf communityacquired bacterial meningitis in adults.
Communityacquired bacterial meningitis in adults with cancer. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Communityacquired bacterial meningitis inflammation of the meninges is most commonly caused by streptococcus pneumoniae or neisseria. To study the incidence, clinical presentation, causative bacteria, and outcome of community acquired bacterial meningitis in adults with cancer. The most common causes of communityacquired bacterial meningitis in adults are streptococcus pneumoniae and neisseria meningitidis. To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community acquired bacterial meningitis in adults. Communityacquired bacterial meningitis causes substantial morbidity and mortality in adults. Bacterial meningitis is a lifethreatening disease that is associated with considerable mortality and morbidity. In this cohort study, we prospectively assessed adults age 16 years with community acquired bacterial meningitis in the netherlands, identified through the national reference laboratory for bacterial meningitis or individual physicians between jan 1, 2006, and july 1, 2014.
Bacterial meningitis in older adults is a wellstudied and serious disease, but few studies have investigated the epidemiology and outcomes of communityacquired meningitis in older adults. To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating communityacquired bacterial meningitis in adults. Communityacquired bacterial meningitis in adults nejm. Observational period was between 1 january 1990 and 31 december 2004. Risk factors and prognosis of seizures in adults with. Hydrocephalus was diagnosed in 26 of 577 episodes 5% and was classified as. The dutch meningitis cohort study, a prospective nationwide observational cohort study in the netherlands, includes 696 episodes of communityacquired acute bacterial meningitis. A prospective cohort study article pdf available in the lancet infectious diseases 163 december 2015 with 539. To improve this knowledge, all episodes of communityacquired bacterial meningitis were prospectively recorded and cases occurring in patients. Jul 15, 20 community acquired bacterial meningitis cabm continues to have a high mortality rate and often results in severe sequelae among survivors. Although the pathogenesis of bacterial meningitis is not completely understood, knowledge of bacterial invasion and entry into the cns is improving. Hydrocephalus was diagnosed in 26 of 577 episodes 5% and was classified as communicating hydrocephalus in all but 1 patient. Communityacquired bacterial meningitis i n adults in the netherlands, 200614.
Methods we conducted a retrospective study of 619 adults in houston, texas, with community acquired meningitis hospitalized between january 1, 2005, and. Epidemiology of invasive meningococcal disease in the netherlands, 19602012. Communityacquired bacterial meningitis cabm is a lifethreatening infection that can be complicated by neurological deficits among. Objective to examine predefined risk factors and outcome of seizures in communityacquired bacterial meningitis cabm. Presented at the 43rd annual meeting of the infectious diseases society of america, san francisco, ca. Community acquired bacterial meningitis inflammation of the meninges is most commonly caused by streptococcus pneumoniae or neisseria meningitidis. Bacterial meningitis in patients with csf leakage can be classified as community acquired, in case of anatomic defects or contiguous spread of infection, or nosocomial or healthcareassociated meningitis after surgery for trauma 5, 7,8. It is widely acknowledged that prompt recognition, appropriate investigation and treatment save lives. Lifethreatening inflammation of the meninges caused by various bacteria.
Threeyear multicenter surveillance of communityacquired. Streptococcus pneumoniae, neisseria meningitidis, and haemophilus influenzae type b hib are the predominant causative pathogens in both adults and children. Acute bacterial meningitis abm is a medical emergency associated with considerable morbidity and mortality. Endocarditis in adults with bacterial meningitis circulation. Jointfluid aspirations were performed in 23 of 48 patients 48% and jointfluid cultures yielded bacteria in 6 of 23 patients 26%.
Update on communityacquired bacterial meningitis sciencedirect. For 74 patients with community acquired bacterial meningitis who died during hospitalization, the underlying and. Some of these are pathogenspecific, while some are shared between. The incidence of communityacquired bacterial meningitis in the general population is estimated around 5100 000 000 000 adults per year. Streptococcus pneumoniae, neisseria meningitidis, and haemophilus influenzae type b hib are the predominant causative pathogens in both adults and children the focus of this topic is on bacterial meningitis acquired in the community. Recurrent bacterial meningitis has been estimated to occur in 4%9% of all patients with communityacquired bacterial meningitis. Communityacquired bacterial meningitis in adults article pdf available in new england journal of medicine 3541. Attributes of good guidelines include validity, reliability, reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary process. To study the incidence, clinical presentation, causative bacteria, and outcome of communityacquired bacterial meningitis in adults with cancer. P 16 years with communityacquired bacterial meningitis in the netherlands, identified through the national reference laboratory for bacterial meningitis or individual physicians between jan 1, 2006, and july 1, 2014. Communityacquired bacterial meningitis in adults practical.
Inclusion and exclusion criteria are described more extensively elsewhere. Various risk factors have been identified for the same. In adults with communityacquired bacterial meningitis, 25 percent have recent otitis. However, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. To identify differences between groups fisher exact statistics and the mannwhitney u test were used. Bacterial meningitis, acute communityacquired is a topic covered in the johns hopkins abx guide to view the entire topic, please sign in or purchase a subscription official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine. Communityacquired group b streptococcal meningitis in adults. Dilemmas in the diagnosis of acute communityacquired. The pathogenesis of bacterial meningitis is based on complex and incompletely understood hostpathogen interactions.
In summary, all patients were aged 16 years and had cerebrospinal fluid csf culture proven bacterial. The incidence of communityacquired bacterial meningitis was highest in 200708, with 172 cases per 100 000 adults per year, and subsequently declined to 094 per 100 000 adults per year in 2014. Acute communityacquired bacterial meningitis in adults admitted to the intensive care unit. Oct 01, 2001 to analyze deaths of adults hospitalized for community acquired bacterial meningitis more accurately, strict definitions of meningitis related causes of death were created in accordance with the criteria of the world health organization and national center for health statistics 20, 21. Pdf acute communityacquired bacterial meningitis in. Hydrocephalus is a rare outcome in communityacquired. Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in survivors. To analyze deaths of adults hospitalized for communityacquired bacterial meningitis more accurately, strict definitions of meningitisrelated causes of death were created in accordance with the criteria of the world health organization and national center for health statistics 20, 21. The escmid guideline advises to start empiric treatment within one hour of arrival in all suspected meningitis cases, and choice of antibiotics needs to be. The focus of this topic is on bacterial meningitis acquired in the community. Acute community acquired bacterial meningitis flashcards. These outcomes have prompted interventions in prevention and treatment. Over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a significant burden of disease in adults, with a mortality of up to 30%. Start studying acute community acquired bacterial meningitis.
Bacterial meningitis is a medical, neurologic, and sometimes. Recent findings indications for cranial imaging in suspected bacterial meningitis varies significantly between guidelines. To identify factors associated with unfavourable inhospital outcome death or disability in adults with communityacquired bacterial meningitis cabm. Communityacquired bacterial meningitis in elderly patients. First, the introduction of conjugate vaccines in europe resulted in the virtual. All adults patients admitted to the participating hospitals with the diagnosis of acute communityacquired bacterial meningitis acabm were included in this study. Case series from a prospective nationwide cohort study from dutch hospitals from 2006 to 2009. Methods we conducted a retrospective study of 619 adults in houston, texas, with communityacquired meningitis hospitalized between january 1, 2005, and. Acute communityacquired bacterial meningitis is a medical emergency, and patients with this disease need immediate medical assessment and treatment. Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting in a high mortality and morbidity throughout the world. Clinical features alone cannot determine whether meningitis. Among them, alcoholism with cirrhosis, uncontrolled diabetes.
Communityacquired bacterial meningitis in adults with. Causative bacteria in communityacquired bacterial meningitis vary depending on age. At that time, it can be downloaded free in pdf format from. Communityacquired bacterial meningitis in adults new england. Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Abstract bacterial meningitis is a medical emergency. Causative bacteria in community acquired bacterial meningitis vary depending on age. It explains the initial assessment and management, the. First, the introduction of conjugate vaccines in europe resulted in the virtual disappearance of. Di lemmas exist in the diagnosis of patients with bacterial meningitis, because clinical. Likewise gram positive organisms were susceptible to most of the antibiotics tested. To aid in this field of research we set out to ascertain the risk and outcome of. The aetiology of acute community acquired bacterial meningitis in children and adults in maputo, mozambique. Bacterial meningitis symptoms, diagnosis and treatment.
Mar 07, 2016 community acquired bacterial meningitis cabm is a lifethreatening infection that can be complicated by neurological deficits among survivors. P initial management, and prevention of meningitis. Communityacquired bacterial meningitis cabm continues to have a high mortality rate and often results in severe sequelae among survivors. Sep 24, 2018 community acquired spontaneously occurring e. Bacterial meningitis is a significant burden of disease and mortality in all age groups worldwide despite the development of effective conjugated vaccines. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. We evaluated incidence and characteristics of patients with cancer included in a nationwide prospective cohort study of adults with community acquired meningitis performed in the netherlands from march 1, 2006, to september 31, 2014. Bacterial meningitis is a serious inflammation of the meninges caused by various bacteria. Hospitalacquired meningitis is rapidly increasing and adding an immense burden to the health system due to the emergence of multidrug resistance isolates. In the past decades the epidemiology and treatment strategies for communityacquired bacterial meningitis have significantly changed. Community acquired bacterial meningitis in adults in the netherlands, 200614. Two hundred and eighty six patients with community acquired bacterial meningitis aged 14 years and more were included in this retrospective cohort study.
Two hundred and eighty six patients with communityacquired bacterial meningitis aged 14 years and more were included in this retrospective cohort study. Community acquired bacterial meningitis in adults request pdf. Meningitis about bacterial meningitis infection cdc. In adults and children after the neonatal period the most common pathogens are streptococcus pneumoniae and neisseria meningitis, while in neonates streptococcus agalactiae group b streptococci. Bacterial meningitis, acute communityacquired johns. Older people more often presented with the triad of fever, neck stiffness, and altered mental status than younger adults 58% vs 36%. All the gram negative isolates were multidrug resistance. Design observational cohort studies setting denmark participants in the derivation cohort, we retrospectively included all adults 15 years of age with cabm in north denmark region from 1998 to 2014 and at hvidovre and hillerod hospitals from 2003 to 2014. Hydrocephalus in adults with communityacquired bacterial.
Bacterial meningitis is very serious and can be deadly. Pathophysiology and treatment of bacterial meningitis ncbi. A case was defined as an adult patient age 16 yrs with communityacquired symptoms of meningitis fever, headache, stiff neck, altered mental status or focal neurological symptoms and cerebrospinal fluid csf white cell count 5 cellsmm 3, who presented to an emergency department ed between january 1. It explains the initial assessment and management, the use of adjunctive corticosteroi.
Communityacquired escherichia coli meningitis with. Communityacquired bacterial meningitis is a serious and lifethreatening disease. Arthritis was recorded in 48 of 696 7% episodes of community acquired bacterial meningitis in adults. Update and advances in community acquired bacterial meningitis. Only colistin and imipenem were effective antibiotics against them. Dilemmas in the diagnosis of acute communityacquired bacterial. To create and test a prognostic model for persons with community acquired bacterial meningitis and to determine whether antibiotic timing influences clinical outcome.
Communityacquired recurrent bacterial meningitis in adults. All adults patients admitted to the participating hospitals with the diagnosis of acute community acquired bacterial meningitis acabm were included in this study. To aid in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community. Pdf communityacquired bacterial meningitis in adults in. Diagnosis, initial management, and prevention of meningitis.
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