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[Comparative study of meningitis due to Staphylococcus aureus and coagulase-negative Staphylococci in adults]

P Laguna-Del Estal1, A Castañeda-Pastor, M Gil-Navarro

  • 1Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España. pld02m@saludalia.com

Revista De Neurologia
|January 16, 2009
PubMed
Abstract

Insights

Staphylococcus aureus causes severe hospital-acquired meningitis with high mortality, unlike coagulase-negative Staphylococci. This study highlights the risks associated with neurosurgery and devices in Staphylococcus meningitis cases.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Critical Care Medicine

Background:

  • Staphylococcus species are uncommon causes of community-acquired acute bacterial meningitis (ABM).
  • These bacteria are a significant cause of nosocomial meningitis, particularly in hospital settings.
  • This study focuses on adult ABM caused by Staphylococcus aureus and coagulase-negative (CoN) Staphylococci.

Purpose of the Study:

  • To describe and compare cases of acute bacterial meningitis (ABM) caused by Staphylococcus aureus and coagulase-negative Staphylococci in adults.
  • To identify risk factors and outcomes associated with these specific Staphylococcus-related meningitis cases.

Main Methods:

  • Retrospective review of medical records for patients aged 14 years or older diagnosed with ABM.
  • Inclusion criteria required a positive cerebrospinal fluid (CSF) culture for Staphylococcus species.
  • Comparative analysis of clinical features, risk factors, and outcomes between S. aureus and CoN Staphylococci meningitis.

Main Results:

  • Forty cases of Staphylococcus-induced ABM were identified, with 12 caused by S. aureus and 28 by CoN Staphylococci.
  • The incidence of Staphylococcus meningitis increased over the study period, with most cases being nosocomial and post-operative, often linked to neurosurgical devices.
  • S. aureus infections were associated with higher rates of bacteremia, complications, and a significantly higher mortality rate (67%) compared to CoN Staphylococci (0%).

Conclusions:

  • Staphylococcus species are a notable cause of ABM in neurosurgical patients, especially post-operatively or with CSF devices.
  • While CoN Staphylococci meningitis generally has a favorable prognosis, S. aureus meningitis carries a high mortality risk.
  • Management strategies should consider the specific Staphylococcus species and associated risk factors, particularly in neurosurgical contexts.

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