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Clinical characteristics of adult Escherichia coli meningitis

Tzu-Ming Yang1, Cheng-Hsien Lu, Chi-Ren Huang

  • 1Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung Hsien, Taiwan.

Japanese Journal of Infectious Diseases
|June 24, 2005
PubMed

Insights

Adult meningitis caused by Escherichia coli (E. coli) is often linked to post-neurosurgery. Appropriate antibiotics are crucial, but emerging resistance poses treatment challenges.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Meningitis is a serious central nervous system infection.
  • Escherichia coli (E. coli) can cause bacterial meningitis in adults.
  • Limited data exists on E. coli meningitis in adults, especially concerning treatment outcomes.

Purpose of the Study:

  • To analyze the clinical characteristics and therapeutic outcomes of adult patients with meningitis caused solely by E. coli.
  • To identify predisposing factors for E. coli meningitis in adults.
  • To assess the antibiotic susceptibility patterns of E. coli strains causing meningitis.

Main Methods:

  • Retrospective analysis of clinical and laboratory data from 15 adult patients with E. coli meningitis over 18 years (1986-2003).
  • Review of patient demographics, clinical presentations, and treatment regimens.
  • Evaluation of antibiotic susceptibility testing for isolated E. coli strains.

Main Results:

  • E. coli accounted for 5% of adult bacterial meningitis cases with a single pathogen.
  • A post-neurosurgical state was the most significant predisposing factor.
  • All E. coli strains were susceptible to imipenem/meropenem, but resistance to third-generation cephalosporins emerged after 2001.
  • Mortality was 100% in patients without appropriate antibiotics versus 27% in those who received them.

Conclusions:

  • Timely and appropriate antibiotic therapy is critical for managing adult E. coli meningitis.
  • Emerging resistance to third-generation cephalosporins presents a therapeutic challenge for empirical antibiotic selection in post-neurosurgical meningitis.
  • Further large-scale studies are needed to establish definitive treatment conclusions.

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