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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
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Community-acquired pneumonia in patients with bacterial meningitis: a prospective nationwide cohort study

A H A Figueiredo1, M C Brouwer1, M W Bijlsma1

  • 1Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|September 17, 2019
PubMed
Abstract

Insights

Pneumonia occurring with bacterial meningitis is common and significantly worsens patient outcomes. This co-infection increases the risk of unfavorable outcomes and mortality in patients with community-acquired bacterial meningitis.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Critical Care Medicine

Background:

  • Community-acquired bacterial meningitis can present with concurrent pneumonia, a focus of infection.
  • The impact of pneumonia on the clinical course and outcomes of bacterial meningitis is not well understood.

Purpose of the Study:

  • To investigate the presenting characteristics of bacterial meningitis patients with pneumonia.
  • To analyze the clinical course and outcomes of meningitis patients who also have pneumonia upon admission.

Main Methods:

  • A nationwide prospective cohort study of adult patients with community-acquired bacterial meningitis and pneumonia on admission was conducted from March 2006 to June 2017.
  • Logistic regression analysis was used to identify predictors of pneumonia and its effect on outcomes.

Main Results:

  • Pneumonia was present in 17% of bacterial meningitis episodes, frequently caused by Streptococcus pneumoniae.
  • Pneumonia on admission was associated with older age, alcoholism, cancer, and S. pneumoniae infection.
  • An unfavorable outcome (Glasgow Outcome Scale 1-4) occurred in 55% of cases, with a 28% mortality rate, both independently linked to pneumonia.

Conclusions:

  • Pneumonia is a frequent co-infection in bacterial meningitis.
  • Pneumonia at admission is an independent predictor of unfavorable outcomes and increased mortality in bacterial meningitis patients.
Keywords:
Acute meningitisBacterial infectionsMeningitisPneumococcal infectionsPneumonia

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