1. Predictors of inferior outcome in community acquired bacterial meningitis.
- Author
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Streharova A, Krcmery V, Kisac P, Kalavsky E, Holeckova K, Lesnakova A, Luzinsky L, Adamkovicova E, Pavlikova Z, Spilakova N, Kacunova B, Dovalova V, Wiczmandyova O, Spanik S, Liskova A, Chovancova D, Kovac M, Ondrusova A, Bauer F, Benca J, Rudinsky B, Sramka M, Kralova J, Krsakova J, Krumpolcova M, Findova L, Svabova V, Sladeckova V, Seckova S, Saniova J, Pavlicova B, Taziarova M, Bukovinova P, Kolenova A, Horvathova E, Hvizdak F, Luzica R, Rolnikova B, Bocakova A, Grey E, Bielova M, Huttova M, Sabo I, and Jalili N
- Subjects
- Alcoholism mortality, Brain Injuries mortality, Chi-Square Distribution, Community-Acquired Infections complications, Community-Acquired Infections mortality, Community-Acquired Infections therapy, Diabetes Mellitus, Gram-Negative Bacterial Infections mortality, Gram-Negative Bacterial Infections therapy, Humans, Meningitis, Bacterial complications, Meningitis, Bacterial mortality, Risk Factors, Slovakia, Treatment Failure, Alcoholism complications, Brain Damage, Chronic etiology, Brain Injuries complications, Gram-Negative Bacterial Infections complications, Meningitis, Bacterial therapy
- Abstract
The aim of this study was to assess mortality and sequellae within cases from Nationwide survey of community acquired meningitis and identify risk factors for inferior outcome. Risk factors such as underlying disease (diabetes mellitus, cancer, trauma, neonatal age, splenectomy, alcoholism, sepsis, other infections), etiology, clinical symptoms and outcome (death, improvement and cured after modifications of ATB therapy, cured without change of therapy, cured with neurologic sequellae) were recorded and analysed with univariate analysis (chi2 or t test for trends, CDC Atlanta 2004). Analysing risk factors for inferior outcome (death or cured with neurologic sequellae), we compared patients who died or survived with neurologic sequellae to all patients with community acquired bacterial meningitis. Univariate analysis showed that trauma (p<0.05), alcohol abuse (p<0.05), diabetes, S. aureus (p<0.05) and gram-negative etiology (A. baumannii, Ps. aeruginosa or Enterobacteriaceae) (36% vs. 11,9%, p<0.05) were predicting inferior outcome. Analysing risk factors for treatment failure (death or failed but cured after change of antibiotic treatment) prior sepsis (34.1% vs. 13.9%, p<0.01) and gram-negative etiology (25% vs. 11.9%, p<0.02) were statistically significant predictors of treatment failure. Neisseria meningitis had less failures (p<0.05). Concerning infection associated mortality again diabetes mellitus (p<0.05), alcoholism (p<0.05) staphylococcal and gram-negative etiology (p<0.05) were significant predictors of death. N. meningitis had surprisingly less treatment failures (appropriate and rapid initial therapy). Neurologic sequellae were more common in patients with alcohol abuse (p<0.05), craniocerbral trauma (p<0.05) and less common in meningitis with pneumococcal etiology (p<0.05).
- Published
- 2007