Jacob Bodilsen1, Matthijs C Brouwer2, Nicolai Kjærgaard3, Marc J Sirks2, Arie van der Ende4, Henrik Nielsen3, Diederik van de Beek2. 1. Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark. Electronic address: Jacob.bodilsen@rn.dk. 2. Department of Neurology, Amsterdam Neuroscience, Academic Medical Centre, Amsterdam, The Netherlands. 3. Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark. 4. Department of Medical Microbiology, Academic Medical Center, Amsterdam Infection & Immunity Institute, Amsterdam, The Netherlands; Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Center, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: We aimed to examine risk factors, presenting characteristics and complications of Escherichia coli community-acquired bacterial meningitis in adults. METHODS: Observational cohort study of adults > 16 years of age with cerebrospinal fluid culture-positive E. coli meningitis in Denmark and the Netherlands. Exclusion criteria were primary brain abscess, previous neurosurgery and nosocomial infections. We analysed baseline characteristics, concomitant infections and neurological complications. Outcome was assessed using the Glasgow Outcome Scale score (GOS) at discharge with GOS 1-4 categorised as unfavourable outcome. RESULTS: We identified 36 patients with a median age of 69 years (interquartile range 61-83) of whom 15 (42%) were females. Immuno-compromise was present in 11 (31%) patients. Nineteen (53%) patients had concomitant infections consisting of urinary tract infections in 13 (36%), pneumonia in three (9%) and septic arthritis in two (6%). Bacteraemia with E. coli was found in 26 of 34 (76%) patients. Thirteen patients died (36%) and unfavourable outcome at discharge occurred in 23 (64%). Deaths were attributed to systemic complications in 12 (92%) patients. CONCLUSION: Community-acquired E. coli meningitis in adults is a severe disease that primarily occurs in elderly patients with concomitant infections and an immunocompromised state. Outcome is often poor and mainly caused by systemic complications.
OBJECTIVES: We aimed to examine risk factors, presenting characteristics and complications of Escherichia coli community-acquired bacterial meningitis in adults. METHODS: Observational cohort study of adults > 16 years of age with cerebrospinal fluid culture-positive E. coli meningitis in Denmark and the Netherlands. Exclusion criteria were primary brain abscess, previous neurosurgery and nosocomial infections. We analysed baseline characteristics, concomitant infections and neurological complications. Outcome was assessed using the Glasgow Outcome Scale score (GOS) at discharge with GOS 1-4 categorised as unfavourable outcome. RESULTS: We identified 36 patients with a median age of 69 years (interquartile range 61-83) of whom 15 (42%) were females. Immuno-compromise was present in 11 (31%) patients. Nineteen (53%) patients had concomitant infections consisting of urinary tract infections in 13 (36%), pneumonia in three (9%) and septic arthritis in two (6%). Bacteraemia with E. coli was found in 26 of 34 (76%) patients. Thirteen patients died (36%) and unfavourable outcome at discharge occurred in 23 (64%). Deaths were attributed to systemic complications in 12 (92%) patients. CONCLUSION: Community-acquired E. coli meningitis in adults is a severe disease that primarily occurs in elderly patients with concomitant infections and an immunocompromised state. Outcome is often poor and mainly caused by systemic complications.
Authors: V Pota; M B Passavanti; F Coppolino; F Di Zazzo; L De Nardis; R Esposito; M Fiore; G S R C Mangoni di Santostefano; C Aurilio; P Sansone; M C Pace Journal: J Med Case Rep Date: 2021-03-29
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Authors: Damon P Eisen; Elizabeth Hamilton; Jacob Bodilsen; Rasmus Køster-Rasmussen; Alexander J Stockdale; James Miner; Henrik Nielsen; Olga Dzupova; Varun Sethi; Rachel K Copson; Miriam Harings; Oyelola A Adegboye Journal: Sci Rep Date: 2022-01-13 Impact factor: 4.379