Clinical Aspects of Bacterial Meningitis in Cerebrospinal Fluid Culture Positive Patients in a Tertiary Care University Hospital

Background: There have been previous clinical research studies on clinical manifestations of meningitis in adults or children; however, few have focused on including both groups and none on the causative organism and its susceptibilities to antibiotics. Here we describe the distribution of causative organism and its antibiotic susceptibilities of meningitis from spinal fluid positive patients of a university hospital. Methods: Cases of spinal fluid culture results from admitted patients in Kyung Hee Medical Center from July 2004 to June 2009 were analyzed retrospectively by their medical records and laboratory results. Results: Ninety five cases of positive spinal fluid culture results were obtained and 25 cases fit the diagnostic criteria for bacterial meningitis. 5 cases were spontaneous meningitis and 20 were post cranial surgery meningitis. Among the 25 patients, fever was the most common clinical presentation (100%) and ventriculoperitoneal shunt was the most common causative procedure of post cranial surgery meningitis. Streptococcus pneumoniae for spontaneous meningitis and Acinetobacter species for post cranial surgery meningitis was identified as the most common causative organisms. Conclusion: Recurrent positive spinal fluid culture results of the same organism was found in expired patients due to post cranial surgery meningitis and also from the culture results of the wound and intra-cranial inserted instruments, suggesting post operative infection control is directly related to morbidity requiring adequate usage of antibiotics rather than empirical broad spectrum antibiotics. (Korean J Clin Microbiol 2011;14:1-6)