Community-acquired meningitis caused by beta-haemolytic streptococci in adults

a nationwide population-based cohort study

DASGIB study group, Lykke Larsen (Medlem af forfattergruppering)

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

The objective of this study was to examine the clinical presentation of community-acquired beta-haemolytic streptococcal (BHS) meningitis in adults. This is a nationwide population-based cohort study of adults (≥ 16 years) with BHS meningitis verified by culture or polymerase chain reaction of the cerebrospinal fluid (CSF) from 1993 to 2005. We retrospectively evaluated clinical and laboratory features and assessed outcome by Glasgow Outcome Scale (GOS). We identified 54 adults (58% female) with a median age of 65 years (IQR 55-73). Mean incidence rate was 0.7 cases per 1,000,000 person-years. Alcohol abuse was noted among 11 (20%) patients. Group A streptococci (GAS) were found in 17 (32%) patients, group B (GBS) in 18 (34%), group C (GCS) in four (8%) and group G (GGS) in 14 (26%). Patients with GAS meningitis often had concomitant otitis media (47%) and mastoiditis (30%). Among patients with GBS, GCS or GGS meningitis, the most frequent concomitant focal infections were bone and soft tissue infections (19%) and endocarditis (16%). In-hospital mortality was 31% (95% CI 19-45), and 63% (95% CI 49-76) had an unfavourable outcome at discharge (GOS < 5). BHS meningitis in adults is primarily observed among the elderly and has a poor prognosis. GAS meningitis is primarily associated with concomitant ear-nose-throat infection.

OriginalsprogEngelsk
TidsskriftEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
Vol/bind38
Udgave nummer12
Sider (fra-til)2305-2310
ISSN0934-9723
DOI
StatusUdgivet - dec. 2019

Fingeraftryk

Meningitis
Cohort Studies
Population
Mastoiditis
Soft Tissue Infections
Otitis Media
Hospital Mortality
Nose
Alcoholism
Cerebrospinal Fluid
Polymerase Chain Reaction
Incidence

Citer dette

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abstract = "The objective of this study was to examine the clinical presentation of community-acquired beta-haemolytic streptococcal (BHS) meningitis in adults. This is a nationwide population-based cohort study of adults (≥ 16 years) with BHS meningitis verified by culture or polymerase chain reaction of the cerebrospinal fluid (CSF) from 1993 to 2005. We retrospectively evaluated clinical and laboratory features and assessed outcome by Glasgow Outcome Scale (GOS). We identified 54 adults (58{\%} female) with a median age of 65 years (IQR 55-73). Mean incidence rate was 0.7 cases per 1,000,000 person-years. Alcohol abuse was noted among 11 (20{\%}) patients. Group A streptococci (GAS) were found in 17 (32{\%}) patients, group B (GBS) in 18 (34{\%}), group C (GCS) in four (8{\%}) and group G (GGS) in 14 (26{\%}). Patients with GAS meningitis often had concomitant otitis media (47{\%}) and mastoiditis (30{\%}). Among patients with GBS, GCS or GGS meningitis, the most frequent concomitant focal infections were bone and soft tissue infections (19{\%}) and endocarditis (16{\%}). In-hospital mortality was 31{\%} (95{\%} CI 19-45), and 63{\%} (95{\%} CI 49-76) had an unfavourable outcome at discharge (GOS < 5). BHS meningitis in adults is primarily observed among the elderly and has a poor prognosis. GAS meningitis is primarily associated with concomitant ear-nose-throat infection.",
author = "Nicolai Kj{\ae}rgaard and Jacob Bodilsen and Justesen, {Ulrik Stenz} and Sch{\o}nheyder, {Henrik Carl} and Andersen, {Christian {\O}stergaard} and Svend Ellermann-Eriksen and Esad Dzajic and Ming Chen and M{\o}ller, {Jens Kj{\o}lseth} and Dessau, {Ram Benny} and Niels Frimodt-M{\o}ller and Jarl{\o}v, {Jens Otto} and Henrik Nielsen and {DASGIB study group} and Lykke Larsen",
year = "2019",
month = "12",
doi = "10.1007/s10096-019-03678-w",
language = "English",
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pages = "2305--2310",
journal = "European Journal of Clinical Microbiology & Infectious Diseases",
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TY - JOUR

T1 - Community-acquired meningitis caused by beta-haemolytic streptococci in adults

T2 - a nationwide population-based cohort study

AU - Kjærgaard, Nicolai

AU - Bodilsen, Jacob

AU - Justesen, Ulrik Stenz

AU - Schønheyder, Henrik Carl

AU - Andersen, Christian Østergaard

AU - Ellermann-Eriksen, Svend

AU - Dzajic, Esad

AU - Chen, Ming

AU - Møller, Jens Kjølseth

AU - Dessau, Ram Benny

AU - Frimodt-Møller, Niels

AU - Jarløv, Jens Otto

AU - Nielsen, Henrik

AU - DASGIB study group

A2 - Larsen, Lykke

PY - 2019/12

Y1 - 2019/12

N2 - The objective of this study was to examine the clinical presentation of community-acquired beta-haemolytic streptococcal (BHS) meningitis in adults. This is a nationwide population-based cohort study of adults (≥ 16 years) with BHS meningitis verified by culture or polymerase chain reaction of the cerebrospinal fluid (CSF) from 1993 to 2005. We retrospectively evaluated clinical and laboratory features and assessed outcome by Glasgow Outcome Scale (GOS). We identified 54 adults (58% female) with a median age of 65 years (IQR 55-73). Mean incidence rate was 0.7 cases per 1,000,000 person-years. Alcohol abuse was noted among 11 (20%) patients. Group A streptococci (GAS) were found in 17 (32%) patients, group B (GBS) in 18 (34%), group C (GCS) in four (8%) and group G (GGS) in 14 (26%). Patients with GAS meningitis often had concomitant otitis media (47%) and mastoiditis (30%). Among patients with GBS, GCS or GGS meningitis, the most frequent concomitant focal infections were bone and soft tissue infections (19%) and endocarditis (16%). In-hospital mortality was 31% (95% CI 19-45), and 63% (95% CI 49-76) had an unfavourable outcome at discharge (GOS < 5). BHS meningitis in adults is primarily observed among the elderly and has a poor prognosis. GAS meningitis is primarily associated with concomitant ear-nose-throat infection.

AB - The objective of this study was to examine the clinical presentation of community-acquired beta-haemolytic streptococcal (BHS) meningitis in adults. This is a nationwide population-based cohort study of adults (≥ 16 years) with BHS meningitis verified by culture or polymerase chain reaction of the cerebrospinal fluid (CSF) from 1993 to 2005. We retrospectively evaluated clinical and laboratory features and assessed outcome by Glasgow Outcome Scale (GOS). We identified 54 adults (58% female) with a median age of 65 years (IQR 55-73). Mean incidence rate was 0.7 cases per 1,000,000 person-years. Alcohol abuse was noted among 11 (20%) patients. Group A streptococci (GAS) were found in 17 (32%) patients, group B (GBS) in 18 (34%), group C (GCS) in four (8%) and group G (GGS) in 14 (26%). Patients with GAS meningitis often had concomitant otitis media (47%) and mastoiditis (30%). Among patients with GBS, GCS or GGS meningitis, the most frequent concomitant focal infections were bone and soft tissue infections (19%) and endocarditis (16%). In-hospital mortality was 31% (95% CI 19-45), and 63% (95% CI 49-76) had an unfavourable outcome at discharge (GOS < 5). BHS meningitis in adults is primarily observed among the elderly and has a poor prognosis. GAS meningitis is primarily associated with concomitant ear-nose-throat infection.

U2 - 10.1007/s10096-019-03678-w

DO - 10.1007/s10096-019-03678-w

M3 - Journal article

VL - 38

SP - 2305

EP - 2310

JO - European Journal of Clinical Microbiology & Infectious Diseases

JF - European Journal of Clinical Microbiology & Infectious Diseases

SN - 0934-9723

IS - 12

ER -