336. Characteristics of Acute Bacterial Meningitis and Predictors of Mortality

Background Acute bacterial meningitis is a medical emergency associated with morbidity and mortality. The aim of the study was to describe clinical features, causative organisms and predictors of death among patients presented with community-acquired acute bacterial meningitis. Methods This retrospective study was conducted at Nakhonpathom Hospital, a 700-bed tertiary care hospital in Thailand during July 2013 and August 2017. The data on demography, clinical presentation, and outcome were collected. Factors associated with death were analysed. Results During study period, there were 55 patients. Median age was 45 (range 19 to 89) years and 38 (69%) were male. Median duration of symptom before hospitalization were 2 (range 1 to 6) days. The most common presenting symptoms were fever (98%), headache (94%), and decreased level of consciousness (75%). The classic triad of fever, headache, and neck stiffness was documented in 53%. Computed tomography scan of brain were abnormal among 57% of 35 patients. Bacteria was isolated in CSF or blood in 40 patients (73%). The most common isolates were S. agalactiae (17 cases), S. pneumoniae (4 cases) and Streptococcus group D (4 cases). All isolates of S. agalactiae and S. pneumoniae were penicillin sensitive. The in-hospital mortality was 20%. Factors associated with death were age more than 65 years (44% vs. 13%, P = 0.047), low CSF WBC (178 vs. 439 cells/mm3, P = 0.009), and the presence of hydrocephalus on imaging (67% vs. 9%, P = 0.047). The time interval between patients’ presentation and appropriate antibiotics administration differed significantly for patients who survive and die (22 vs. 0.5 hour, P = 0.016). Conclusion Acute bacterial meningitis remains associated with mortality. Age, CSF WBC, hydrocephalus, and delay antibiotics therapy were associated with outcome. Disclosures All authors: No reported disclosures.