Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea |
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Authors: | S.-Y. Moon D. R. Chung S.-W. Kim H. H. Chang H. Lee D. S. Jung Y.-S. Kim S. I. Jung S. Y. Ryu S. T. Heo C. Moon H. K. Ki J. S. Son K. T. Kwon S. Y. Shin J. S. Lee S. S. Lee J.-Y. Rhee J.-A. Lee M. K. Joung H. S. Cheong K. R. Peck J.-H. Song |
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Affiliation: | 1. Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea 2. Kyungpook National University Hospital, Daegu, South Korea 3. Dong-A University Hospital, Busan, South Korea 4. Chungnam National University Hospital, Daejon, South Korea 5. Chonnam National University Hospital, Gwangju, South Korea 6. Keimyung University Dongsan Medical Center, Daegu, South Korea 7. Gyeongsang National University Hospital, Jinju, South Korea 8. Inje University Busan Paik Hospital, Busan, South Korea 9. Konkuk University Hospital, Seoul, South Korea 10. Kyung Hee University East-West Neo Medical Center, Seoul, South Korea 11. Daegu Fatima Hospital, Daegu, South Korea 12. Cheju National University Hospital, Jeju, South Korea 13. Kangdong Sacred Heart Hospital, Seoul, South Korea 14. Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea 15. Dankook University Hospital, Cheonan, South Korea
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Abstract: | Epidemiologic data on the etiologic organisms is important for appropriate empirical antibiotic treatment of bacterial meningitis. We identified the etiologies of community-acquired bacterial meningitis in Korean adults and the associated epidemiological factors. A retrospective, multicenter nationwide study was carried out. Patients 18 years of age or older with community-acquired bacterial meningitis with a confirmed pathogen were enrolled. Demographic, clinical, and microbiological data were collected. One hundred and ninety-five cases were collected. Streptococcus pneumoniae was the most common pathogen (50.8%), followed by Staphylococcus aureus (10.3%), Klebsiella pneumoniae (7.7%), Listeria monocytogenes (6.7%), and group B Streptococcus (3.1%). The penicillin resistance rate of the S. pneumoniae was 60.3%; 40.0% of the organisms were not susceptible to third-generation cephalosporins. The combination of third-generation cephalosporin with vancomycin was used in 76.3% of cases. Steroids were given before or with the first dose of antibiotics in 37.4% of patients. The 30-day mortality rate was 20.5% and neurological sequelae developed in 15.6% of cases. S. pneumoniae was the most common organism identified in community-acquired bacterial meningitis among Korean adults. S. aureus, K. pneumoniae, L. monocytogenes, and group B Streptococcus were also common. S. pneumoniae had high rates of resistance to penicillin and third-generation cephalosporins. |
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