The changing pattern of bacterial meningitis in adult patients at a large tertiary university hospital in Barcelona, Spain (1982–2010) - 04/01/13
, Virginia Pomar a, c, Natividad Benito a, Pere Coll b
Corresponding author. Tel.: +34 935565624; fax: +34 935565938.Summary |
Background |
We conducted a prospective, observational study in Barcelona (Spain) to determine changes in the spectrum of adult patients with bacterial meningitis (BM) over a 29-year period.
Methods |
The observation was divided into two periods: 1982–1995 (I) and 1996–2010 (II). All patients underwent clinical examination on admission and at discharge following a predefined protocol.
Results |
We evaluated 635 episodes of BM. The most frequent etiologic agents were Neisseria meningitidis and Streptococcus pneumoniae in periods I and II, respectively. Patients in period II were older (Median: 47.5 [95%CI: 23.0–64.5] vs. 58.0 [39.0–73.0] years, P < 0.0001), had a longer interval from admission to therapy (Median: 2.3 [95%CI: 1.0–5.0] vs. 4.0 [2.0–12.0] hours, P < 0.0001), and more frequently had co-morbid conditions (39.1% vs. 62%, P < 0.0001). Meningococcal meningitis decreased by 66% (P < 0.0001), whereas meningitis by Listeria monocytogenes increased by 110% (P = 0.0007) in period II. There were no differences in the overall case-fatality and post-meningitic sequelae rates between both periods.
Conclusions |
BM in adult patients has substantially changed over 29 years in terms of population affected, aetiology, and management, but not in terms of its overall mortality rate and appearance of post-meningitic sequelae.
Le texte complet de cet article est disponible en PDF.Keywords : Bacterial meningitis, Epidemiology pattern, Meningococcal disease, Neisseria meningitidis, Streptococcus pneumoniae, Outcome, Sequelae, Spectrum
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Vol 66 - N° 2
P. 147-154 - février 2013 Retour au numéro
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