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Community-acquired acute bacterial meningitis in the elderly in Turkey

H Erdem1, S Kilic, O Coskun

  • 1Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey. hakanerdem1969@yahoo.com

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|September 8, 2009
PubMed

Insights

Community-acquired bacterial meningitis in the elderly is primarily caused by Streptococcus pneumoniae. Risk factors for fatality include age, stupor, sepsis, and incorrect antibiotic treatment, with overall mortality reaching 21.4% by day 21.

Area of Science:

  • Infectious Diseases
  • Geriatrics
  • Clinical Microbiology

Background:

  • Community-acquired acute bacterial meningitis remains a significant health concern, particularly in elderly populations.
  • Understanding the interplay of clinical, laboratory, and therapeutic factors is crucial for improving outcomes in older adults.

Purpose of the Study:

  • To assess the current status of community-acquired acute bacterial meningitis in elderly patients.
  • To investigate the relationships between clinical presentation, laboratory findings, and treatment parameters in this demographic.

Main Methods:

  • A retrospective cohort study involving 159 culture-positive patients over 50 years old across 28 Turkish institutions.
  • Data collection focused on clinical, laboratory, and therapeutic parameters, including causative pathogens and mortality rates.

Main Results:

  • Streptococcus pneumoniae (69.2%) and Listeria monocytogenes (8.8%) were the most frequent pathogens.
  • Overall mortality increased progressively, reaching 21.4% by day 21. Key risk factors for death included advanced age, stupor, sepsis, and inappropriate antibiotic therapy.
  • Lower cerebrospinal fluid (CSF) leukocyte counts and CSF/blood glucose ratios were observed in non-survivors. Fever was not a significant differentiator between survivors and fatal cases.

Conclusions:

  • The study highlights the critical role of prompt and appropriate antibiotic administration, including antilisterial agents when indicated, in managing bacterial meningitis in the elderly.
  • Identifying risk factors for fatality is essential for targeted interventions and improved patient management, aiming to reduce complications and long-term sequelae.

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