Community-acquired meningitis in adults caused by Escherichia coli in Denmark and The Netherlands.

DASGIB study group

Research output: Contribution to journalJournal articleResearchpeer-review

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.

Original languageEnglish
JournalJournal of Infection
Volume77
Issue number1
Pages (from-to)25-29
ISSN0163-4453
DOIs
Publication statusPublished - Jul 2018

Keywords

  • Bacterial meningitis
  • Concomitant infections
  • Epidemiology
  • Escherichia coli
  • Risk factors
  • Community-Acquired Infections/complications
  • Prognosis
  • Escherichia coli/isolation & purification
  • Humans
  • Middle Aged
  • Risk Factors
  • Male
  • Escherichia coli Infections/cerebrospinal fluid
  • Meningitis, Bacterial/epidemiology
  • Cross Infection/complications
  • Denmark/epidemiology
  • Aged, 80 and over
  • Female
  • Aged
  • Immunocompromised Host
  • Netherlands/epidemiology
  • Cohort Studies

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