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脑脊液中的细菌负载预测了肺炎球菌脑膜炎的不利结果:一项前性的全国性队列研究
Nora Chekrouni1, Thijs M van Soest1, Ana C da Cruz Campos1
1Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Meibergdreef, Amsterdam, The Netherlands.
概括
在肺炎球菌脑膜炎的成年人中,脑脊液 (CSF) 的高细菌负载与增加的并发症和不良结果有关. 这一发现强调了细菌负载作为患者预后的关键预测因素.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 肺炎球菌脑膜炎是一种严重的感染,具有显著的发病率和死亡率.
- 在大脑脊髓液 (CSF) 中细菌定量对于预测成年肺炎球菌脑膜炎的结果的作用需要进一步阐明.
研究的目的:
- 调查诊断为肺炎球菌脑膜炎的成年患者中CSF细菌负荷和临床结果之间的关联.
- 为了确定CSF细菌负载是否预测并发症和不良结果.
主要方法:
- 来自152名患有社区感染肺炎球菌脑膜炎的成年患者的脑脊髓液样本中的量化细菌负载.
- 测量了补充成分5a (C5a) 的CSF度.
- 分析了细菌负载,C5a水平,临床特征和不良结果之间的关联 (格拉斯哥结果尺度<5).
主要成果:
- 脑液中的细菌负载与白细胞计数或蛋白质水平没有相关性.
- 脊髓中C5a度与脊髓中的细菌负载有中等的相关性 (斯皮尔曼的rho=0.42,p < 0.0001).
- 高脑液细菌负荷独立预测了诸如循环休克和脑血管事件等并发症,以及不良结果和死亡 (调整后OR:2.5,p < 0.001).
结论:
- 升高的CSF细菌负载是成年肺炎球菌脑膜炎并发症的重要预测因素.
- 脑脊液中的细菌负载是肺炎球菌脑膜炎不良结果和死亡率的独立预测因素.
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