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Serratia marcescens meningitis: epidemiology, prognostic factors and treatment outcomes

Yen-Mu Wu1, Po-Chang Hsu, Chien-Chang Yang

  • 1Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|August 29, 2012
PubMed
Abstract

Insights

Serratia marcescens meningitis, often linked to neurosurgery for brain tumors, has a 15.2% mortality rate. Elevated cerebrospinal fluid lactate may predict poor outcomes.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Oncology

Background:

  • Serratia marcescens is a rare cause of central nervous system infections.
  • Meningitis due to S. marcescens is infrequently encountered but can be serious.

Purpose of the Study:

  • To investigate the epidemiology of S. marcescens meningitis.
  • To identify prognostic factors and treatment outcomes for S. marcescens meningitis.

Main Methods:

  • Retrospective analysis of 33 patients with culture-proven S. marcescens meningitis.
  • Data collected from January 2000 to June 2011.

Main Results:

  • 97% of patients had undergone neurosurgery, often for brain solid tumors (54.5%).
  • Mortality rate was 15.2%. Higher Sequential Organ Failure Assessment scores and elevated CSF lactate predicted unfavorable outcomes.
  • CSF lactate concentration ≥2x upper limit of normal was an independent predictor of unfavorable outcomes (OR, 7.20; P=.041).

Conclusions:

  • S. marcescens meningitis is strongly associated with neurosurgical procedures for brain tumors.
  • Elevated CSF lactate may indicate a poor prognosis.
  • Empirical treatment with third-generation cephalosporins appears effective with a low mortality rate.
Keywords:
LactateMeningitisOutcomeSerratia marcescens

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