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Pooled analysis of 899 nosocomial meningitis episodes from Turkey
Oğuz Reşat Sipahi1, Arzu Nazli Zeka2, Meltem Taşbakan1
1Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey.
Background/Aim:
Healthcare-associated meningitis (HCAM) is a relatively rare entity with significant morbidity and mortality. The aim of this study was to systematically review the Turkish medical literature for acute nosocomial meningitis.
Materials And Methods:
One national (ULAKBİM) and two international (www.scopus.com and www.pubmed.com) databases were searched. In addition, abstracts of four national congresses held between 2004 and 2013 were searched for reports for HCAM meningitis.
Results:
Data for 899 HCAM meningitis episodes were obtained from 24 reports. In terms of clinical findings, 177 of 216 (81.9%) had fever (>38 °C), 55 of 64 (85.9%) had high CRP levels, 105 of 132 had leukocytosis (>10,000/mm3), and 241 of 759 had shunt infection. Cerebrospinal fluid culture yielded a pathogen in 689 of 872 nosocomial meningitis episodes. The most common pathogen was Acinetobacter spp. (30.7%), followed by coagulase-negative staphylococci (21.2%) and Staphylococcus aureus (19%). Carbapenem resistance was reported in 18 of 48 (37.5%) Acinetobacter spp. Overall mortality was 160/593 (27%). Pathogen-specific mortality was 55.5% (30/54) for A. baumannii whereas it was 18.9% (7/37) for S. aureus and 2/17 (11,7%) for MRSA.
Conclusion:
Nosocomial meningitis is still a serious and highly fatal disease. More preventive measures should be sought to further decrease HCAM meningitis and the mortality/morbidity related to it.
Insights
Healthcare-associated meningitis (HCAM) remains a severe and often fatal condition. This review highlights Acinetobacter spp. as a leading cause of nosocomial meningitis, emphasizing the urgent need for improved prevention strategies to reduce mortality.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Public Health
Background:
- Healthcare-associated meningitis (HCAM) presents significant morbidity and mortality.
- Acute nosocomial meningitis is a critical concern in healthcare settings.
Purpose of the Study:
- To systematically review Turkish medical literature on acute nosocomial meningitis.
- To identify common pathogens and resistance patterns in HCAM.
Main Methods:
- Searched national (ULAKBİM) and international (Scopus, PubMed) databases.
- Reviewed abstracts from four national congresses (2004-2013).
- Analyzed data from 899 HCAM episodes reported in 24 studies.
Main Results:
- Fever (81.9%), elevated CRP (85.9%), and leukocytosis were common clinical findings.
- Acinetobacter spp. (30.7%) was the most frequent pathogen, followed by coagulase-negative staphylococci (21.2%) and Staphylococcus aureus (19%).
- Carbapenem resistance was noted in 37.5% of Acinetobacter spp.; overall mortality was 27%.
Conclusions:
- Nosocomial meningitis remains a serious and highly fatal disease.
- Acinetobacter spp. poses a significant threat due to high mortality and resistance.
- Enhanced preventive measures are crucial to decrease HCAM incidence and associated mortality.
