[Pathogen spectrum in suppurative meningitis with special reference to a patient sample]

In a five years period (1982 till 1986) the spectrum of pathogenic bacteria and fungi in acute meningitis was analysed. The appearance, spreading and suspected spectrum of pathogens have to be followed by special aspects considering effective therapeutic proceedings. 361 out of 392 positive cerebrospinal fluids (92.1%) were derived from only 3 (neurosurgical, neurological and pediatric department) out of 14 possible departments. Whereas in the pediatric department the classical pathogens of acute meningitis predominated, the patients in the neurosurgical department mainly showed nosocomial infections. There has to be considered the accidental infection, especially in the severely ill patients of the neurosurgical intensive care unit, which favours highly resistant pathogens. Furthermore, to initiate an infection, the pathogenicity of nosocomial microorganisms is not required to be high. The correlation of clinical signs and the proof of pathogens showed that often so called contaminants could be of higher value to be the infectious agent as assumed. Nevertheless, there seemed to be a regression of acute meningitis due to better diagnostic and therapeutic proceedings.