Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea

Eur J Clin Microbiol Infect Dis. 2010 Jul;29(7):793-800. doi: 10.1007/s10096-010-0929-8. Epub 2010 May 1.

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacteria / classification*
  • Bacteria / isolation & purification*
  • Cephalosporins / pharmacology
  • Cephalosporins / therapeutic use
  • Cognition Disorders / etiology
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / epidemiology*
  • Community-Acquired Infections / etiology*
  • Community-Acquired Infections / mortality
  • Female
  • Humans
  • Male
  • Meningitis, Bacterial / complications
  • Meningitis, Bacterial / epidemiology*
  • Meningitis, Bacterial / etiology*
  • Meningitis, Bacterial / mortality
  • Middle Aged
  • Penicillin Resistance
  • Prevalence
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Vancomycin / therapeutic use
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Vancomycin