Epidemiology and clinical characteristics of Klebsiella spp. meningitis in France - 27/02/22
, G. Péan de Ponfilly b, c, e, E. Farfour f, A.-G. Ranc g, V. Fihman h, E. Bille i, L. Dortet j, N. Degand k, P. Morand l, A. Potron m, A. Mizrahi b, c, n, F. Laurent f, C. Le Brun o, T. Guillard p, G. Héry-Arnaud q, C. Piau r, O. Barraud s, L. Ruffier d’Epenoux t, J.-R. Zahar u, A. Le Monnier b, c, ethe GMC study group
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Highlights |
• | Klebsiella spp. meningitis should be considered in patients presenting with meningitis following neurosurgical procedures. |
• | Post-neurosurgery isolates had significantly higher carriage rates of ESBL or acquired AmpC. |
• | The in-hospital case fatality rate was 23.6%, close to that observed in patients with pneumococcal meningitis. |
Abstract |
Objectives |
To describe the epidemiology of Klebsiella spp. meningitis in France with respect to clinical and bacteriological data.
Methods |
We performed a four-year multicenter, retrospective, observational study. The primary objective was to provide a clinical description of patients with Klebsiella spp. meningitis. Secondary objectives were to compare community-acquired meningitis and healthcare-associated meningitis and to analyze factors associated with mortality.
Results |
We enrolled 131 patients with Klebsiella spp. meningitis. Eighty-two (62.6%) infections were reported following neurosurgery. Twenty-eight strains (21.4%) were resistant to third-generation cephalosporins (3GC). The median [IQR] cellularity was 980/mm3 [116–5550], the median protein level was 5.67 [1.62–9] g/L and the median CSF glucose level was 2.5 [0–3.4] mmol/L. The in-hospital mortality rate was 23.6%. Community-acquired meningitis isolates were more frequently susceptible to 3GC than isolates from healthcare-associated meningitis (89.2% versus 72%; P=0.04). Comorbidities reported for patients with community-acquired meningitis were mainly diabetes mellitus and liver cirrhosis. In multivariate analysis, focal neurological disorder at the time of diagnosis was the only factor associated with in-hospital mortality (P=0.01).
Conclusions |
Purulent meningitis caused by Klebsiella spp. needs to be considered in patients with community-acquired meningitis and preexisting conditions, as well as in case of meningitis following neurosurgical procedures.
Le texte complet de cet article est disponible en PDF.Keywords : Meningitis, Klebsiella pneumoniae, Nosocomial infection, Neurosurgery
Plan
Vol 52 - N° 2
P. 82-86 - mars 2022 Retour au numéro
Article précédent
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