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Streptococcal meningitis in adults: therapeutic outcomes and prognostic factors
1Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan, ROC. chlu99@ms44.url.com.tw
Abstract:
Thirty-eight patients with streptococcal meningitis, aged 17-75 years, have been identified over a period of 13.5 years. Among these 38 patients, 35 had community-acquired infections, and the other three had nosocomial infections. Twelve of the 38 patients were found to have postneurosurgical forms and 26 to have spontaneous forms. These 38 cases of streptococci included Streptococcus (S.) pneumoniae in 19 cases, viridans group streptococci in 13, non-A, non-B, and non-D streptococci in three, Group D streptococci in one, and Group B streptococci (S. agalactiae) in two. Although one case was found to have penicillin-resistant S. pneumoniae PRSP in 1994, multi-antibiotic resistant strains were rare in this study. Therapeutic outcomes varied according to the different species of streptococci. In this study, the overall mortality rate was 34%. In the multiple logistic regression analysis, only initial consciousness level and the presence of seizure were strongly associated with the mortality rate even after other potentially confounding factors were adjusted for. Early diagnosis and the use of appropriate antibiotics are essential for survival.
Insights
Streptococcal meningitis, a serious infection, was studied in 38 patients. Streptococcus pneumoniae was the most common cause, and while antibiotic resistance was rare, mortality remained high at 34%.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Streptococcal meningitis is a significant cause of central nervous system infection.
- Understanding the epidemiology and outcomes of streptococcal meningitis is crucial for effective management.
Purpose of the Study:
- To analyze the characteristics, causative streptococcal species, and therapeutic outcomes of streptococcal meningitis.
- To identify factors associated with mortality in patients with streptococcal meningitis.
Main Methods:
- Retrospective analysis of 38 patients diagnosed with streptococcal meningitis over 13.5 years.
- Identification of causative streptococcal species and assessment of antibiotic resistance.
- Statistical analysis, including multiple logistic regression, to determine mortality predictors.
Main Results:
- Streptococcus pneumoniae was the most frequent pathogen (19 cases).
- Community-acquired infections (35 cases) predominated over nosocomial infections (3 cases).
- The overall mortality rate was 34%, with initial consciousness level and seizure presence being significant predictors.
Conclusions:
- Early diagnosis and appropriate antibiotic therapy are critical for improving survival in streptococcal meningitis.
- While multi-antibiotic resistant strains were rare, outcomes varied by streptococcal species.
- Consciousness level and seizures are key indicators for predicting mortality.