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[Bacterial meningitis due to gram-negative bacilli in adults]

Pedro Laguna-del Estal1, Pablo García-Montero, María Agud-Fernández

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

Revista De Neurologia
|April 24, 2010
PubMed
Abstract

Insights

Gram-negative bacilli rarely cause spontaneous meningitis in adults but are a common cause of post-neurosurgical meningitis. This serious infection has a high mortality rate, emphasizing the need for vigilance in at-risk populations.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Context:

  • Gram-negative bacilli are a known cause of neonatal meningitis.
  • Adult meningitis typically involves other pathogens, with gram-negative bacilli being rare without specific risk factors.

Purpose:

  • To investigate the incidence and characteristics of meningitis caused by gram-negative bacilli (MGNB) in adults over a 25-year period.
  • To identify risk factors and outcomes associated with MGNB in the adult population.

Summary:

  • A 25-year hospital-based study identified 15 cases of adult MGNB, representing 10.5% of bacterial meningitis with identified etiology.
  • The majority of cases (80%) were post-neurosurgical, with recent surgery or neurosurgical devices as significant risk factors.
  • Common causative agents included Pseudomonas aeruginosa and Escherichia coli; mortality was 20%.

Impact:

  • This study highlights that while rare, gram-negative bacilli are a significant cause of meningitis in adults, particularly post-neurosurgery.
  • The findings underscore the high mortality rate associated with MGNB in adults, necessitating prompt diagnosis and management.
  • Understanding these risk factors can guide preventative strategies and improve patient outcomes in neurosurgical and high-risk populations.

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