A hospital-based study on etiology and prognosis of bacterial meningitis in adults

AbstractBacterial meningitis is a neurological emergency with high morbidity and mortality. We herein investigated clinical features, etiology, antimicrobial susceptibility profiles, and prognosis of bacterial meningitis in adults from a single tertiary center. We retrospectively reviewed medical records of patients with laboratory-confirmed bacterial meningitis from 2007 to 2016. Patients with recent neurosurgery, head trauma, or indwelling neurosurgical devices were classified as having healthcare-related meningitis. Causative microorganisms were identified by analyzing cerebrospinal fluid (CSF) and blood cultures, and antimicrobial susceptibility profiles were evaluated. We performed multiple logistic regression analysis to identify factors associated with unfavorable outcomes. We identified 161 cases (age, 55.9 ± 15.5 years; male, 50.9%), of which 43 had community-acquired and 118 had healthcare-related meningitis. CSF and blood culture positivity rates were 91.3% and 30.4%, respectively. In community-acquired meningitis patients, Klebsiella pneumoniae (25.6%) was the most common isolate, followed by Streptococcus pneumoniae (18.6%) and Listeria monocytogenes (11.6%). The susceptibility rates of K. pneumoniae to ceftriaxone, cefepime, and meropenem were 85.7%, 81.3%, and 100%, respectively. Among healthcare-related meningitis patients, the most common bacterial isolates were coagulase-negative staphylococci (28.0%), followed by Staphylococcus aureus (16.1%) and Enterobacter spp. (13.6%). Neurological complications occurred in 39.1% of the patients and the 3-month mortality rate was 14.8%. After adjusting for covariates, unfavorable outcome was significantly associated with old age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00–1.06), neurological complications (OR 4.53, 95% CI 1.57–13.05), and initial Glasgow coma scale ≤ 8 (OR 19.71, 95% CI 4.35–89.40). Understanding bacterial pathogens and their antibiotic susceptibility may help optimize antimicrobial therapy in adult bacterial meningitis.

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Antimicrobial susceptibility profiles associated with bacterial meningitis among children: A referral hospital-based study in Iran

Acta Microbiologica et Immunologica Hungarica ◽

10.1556/amicr.58.2011.4.3 ◽

2011 ◽

Vol 58 (4) ◽

pp. 273-278 ◽

Cited By ~ 1

Author(s):

Mohammad Taghi Haghi-Ashtiani ◽

Setareh Mamishi ◽

Nasrin Shayanfar ◽

Masoud Mohammadpour ◽

Bahareh Yaghmaei ◽

...

Keyword(s):

Bacterial Meningitis ◽

Antimicrobial Susceptibility ◽

Referral Hospital ◽

Susceptibility Profiles

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633. Incidence, Microbial Etiology and Antibiotic Resistance Patterns with Special Reference to Shunt Infections in Neurosurgery at a Tertiary Center in North India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.701 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S293-S294

Author(s):

Manisha Gupta ◽

Tapan Dhole

Keyword(s):

Infection Rate ◽

Antibiotic Sensitivity ◽

North India ◽

High Morbidity ◽

Coagulase Negative Staphylococci ◽

Vp Shunt ◽

India Ink ◽

Shunt Procedure ◽

Sensitivity Pattern ◽

Tertiary Center

Abstract Background Ventriculoperitoneal (VP) shunt is one of the commonest procedures in neurosurgical practice. A significant problem encountered in shunt procedures is infection, with infection rate ranging from 2 to 27%, often with poor outcome. The objectives of the study were to retrospectively evaluate the infection rate associated with central nervous system (CNS) shunts, assess the frequency of the pathogens as well as their antibiotic sensitivity pattern to aim at suitable prophylaxis. Methods Materials and Methods. Retrospective study conducted in the Microbiology Department, SGPGI, Lucknow from December 2017 to August 2018. A total of 168 CSF samples were received with a suspected shunt infection. Samples were analyzed by wet mount, India ink, gram stain and inoculated on blood agar and MacConkey agar. Identification and AST were done by MALDI- TOF system (VITEK-MS) and Vitek 2.0 automated sensitivity system. Results During the study period, 37/168(22.02%) CSF were positive by culture. Most frequently isolated pathogen was Acinetobacter baumannii 20/37(54.05%), followed by Staphylococcus aureus 06/37 (16.20%), Enterococcus faecalis 04/37(10.81%) coagulase negative staphylococci- CONS 04/37(10.81%), Klebsiella pneumoniae 2/37 (5.40%)and Escherichia coli 1/37(2.70%). 100% of A. baumannii and E. coli strains were found to be XDR and carbapenem-resistant showing susceptibility to minocycline and colistin only. All strains of K.pneumoniae were MDR. 66.7% S.aureus were MRSA and showed 100% resistance to fluoroquinolone. A similar pattern was seen in CONS. 25% of Enterococci were found to be vancomycin resistant. Conclusion Discussion and Conclusion. The antibiotic sensitivity pattern suggests aminoglycosides, colistin and vancomycin to be a better choice of antibiotics either prophylactically/therapeutically, which may result in effective sterilization of the CSF. Infections following VP shunt procedure are secondary to catheter blockage complicating the results of surgery and are associated with high morbidity and mortality rates. Disclosures All authors: No reported disclosures.

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Etiology, antimicrobial susceptibility profiles, and mortality associated with bacterial meningitis among children in Egypt

Annals of Epidemiology ◽

10.1016/s1047-2797(03)00075-9 ◽

2004 ◽

Vol 14 (1) ◽

pp. 44-48 ◽

Cited By ~ 30

Author(s):

F Youssef

Keyword(s):

Bacterial Meningitis ◽

Antimicrobial Susceptibility ◽

Susceptibility Profiles

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Antimicrobial susceptibility profiles of bacterial isolates from intra-abdominal and skin and skin structure infections in Eastern and Western Europe

10.26226/morressier.56d6be7ad462b80296c97cb5 ◽

2016 ◽

Author(s):

Daniel Sahm

Keyword(s):

Antimicrobial Susceptibility ◽

Western Europe ◽

Bacterial Isolates ◽

Skin Structure ◽

Susceptibility Profiles ◽

Eastern And Western Europe

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Antimicrobial susceptibility profiles of Gram-negative bacilli isolated from patients with hepatobiliary infections in China: results from the study for monitoring antimicrobial resistance trends (SMART), 2006–2013

10.26226/morressier.56d5ba2cd462b80296c969c0 ◽

2016 ◽

Author(s):

Qiwen Yang

Keyword(s):

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Gram Negative ◽

Susceptibility Profiles

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Temporal Variations in Patterns of Clostridioides difficile Strain Diversity and Antibiotic Resistance in Thailand

Antibiotics ◽

10.3390/antibiotics10060714 ◽

2021 ◽

Vol 10 (6) ◽

pp. 714

Author(s):

Supapit Wongkuna ◽

Tavan Janvilisri ◽

Matthew Phanchana ◽

Phurt Harnvoravongchai ◽

Amornrat Aroonnual ◽

...

Keyword(s):

Antibiotic Resistance ◽

Antimicrobial Susceptibility ◽

Reference Strain ◽

Toxin Production ◽

Temporal Variations ◽

Toxin Gene ◽

Data Sets ◽

Clostridioides Difficile ◽

Life Threatening ◽

Susceptibility Profiles

Clostridioides difficile has been recognized as a life-threatening pathogen that causes enteric diseases, including antibiotic-associated diarrhea and pseudomembranous colitis. The severity of C. difficile infection (CDI) correlates with toxin production and antibiotic resistance of C. difficile. In Thailand, the data addressing ribotypes, toxigenic, and antimicrobial susceptibility profiles of this pathogen are scarce and some of these data sets are limited. In this study, two groups of C. difficile isolates in Thailand, including 50 isolates collected from 2006 to 2009 (THA group) and 26 isolates collected from 2010 to 2012 (THB group), were compared for toxin genes and ribotyping profiles. The production of toxins A and B were determined on the basis of toxin gene profiles. In addition, minimum inhibitory concentration of eight antibiotics were examined for all 76 C. difficile isolates. The isolates of the THA group were categorized into 27 A−B+CDT− (54%) and 23 A-B-CDT- (46%), while the THB isolates were classified into five toxigenic profiles, including six A+B+CDT+ (23%), two A+B+CDT− (8%), five A−B+CDT+ (19%), seven A−B+CDT− (27%), and six A−B−CDT− (23%). By visually comparing them to the references, only five ribotypes were identified among THA isolates, while 15 ribotypes were identified within THB isolates. Ribotype 017 was the most common in both groups. Interestingly, 18 unknown ribotyping patterns were identified. Among eight tcdA-positive isolates, three isolates showed significantly greater levels of toxin A than the reference strain. The levels of toxin B in 3 of 47 tcdB-positive isolates were significantly higher than that of the reference strain. Based on the antimicrobial susceptibility test, metronidazole showed potent efficiency against most isolates in both groups. However, high MIC values of cefoxitin (MICs 256 μg/mL) and chloramphenicol (MICs ≥ 64 μg/mL) were observed with most of the isolates. The other five antibiotics exhibited diverse MIC values among two groups of isolates. This work provides evidence of temporal changes in both C. difficile strains and patterns of antimicrobial resistance in Thailand.

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Speciation and Antibiotic Susceptibilities of Coagulase Negative Staphylococci Isolated from Ocular Infections

Antibiotics ◽

10.3390/antibiotics10060721 ◽

2021 ◽

Vol 10 (6) ◽

pp. 721

Author(s):

John E. Romanowski ◽

Shannon V. Nayyar ◽

Eric G. Romanowski ◽

Vishal Jhanji ◽

Robert M. Q. Shanks ◽

...

Keyword(s):

Empiric Therapy ◽

Species Level ◽

Opportunistic Pathogens ◽

Coagulase Negative Staphylococci ◽

Biochemical System ◽

Ocular Infections ◽

Antibiotic Susceptibilities ◽

System 2 ◽

Intravitreal Treatment ◽

Susceptibility Profiles

Coagulase-negative staphylococci (CoNS) are frequently occurring ocular opportunistic pathogens that are not easily identifiable to the species level. The goal of this study was to speciate CoNS and document antibiotic susceptibilities from cases of endophthalmitis (n = 50), keratitis (n = 50), and conjunctivitis/blepharitis (n = 50) for empiric therapy. All 150 isolates of CoNS were speciated using (1) API Staph (biochemical system), (2) Biolog GEN III Microplates (phenotypic substrate system), and (3) DNA sequencing of the sodA gene. Disk diffusion antibiotic susceptibilities for topical and intravitreal treatment were determined based on serum standards. CoNS identification to the species level by all three methods indicated that S. epidermidis was the predominant species of CoNS isolated from cases of endophthalmitis (84–90%), keratitis (80–86%), and conjunctivitis/blepharitis (62–68%). Identifications indicated different distributions of CoNS species among endophthalmitis (6), keratitis (10), and conjunctivitis/blepharitis (13). Antibiotic susceptibility profiles support empiric treatment of endophthalmitis with vancomycin, and keratitis treatment with cefazolin or vancomycin. There was no clear antibiotic choice for conjunctivitis/blepharitis. S. epidermidis was the most frequently found CoNS ocular pathogen, and infection by other CoNS appears to be less specific and random. Antibiotic resistance does not appear to be a serious problem associated with CoNS.

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