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Hospital‐based study of the distribution of pathogens in adult bacterial meningitis with underlying disease in Tokyo, Japan
Author(s) -
Takahashi Keiko,
Ogawa Katsuhiko,
Ishikawa Harumi,
Morita Akihiko,
Hara Makoto,
Minami Masayuki,
Shiota Hiroshi,
Suzuki Yutaka,
Teramoto Hiroko,
Ebashi Momoko,
Saito Mari,
Ninomiya Satoko,
Akimoto Takayoshi,
Shiobara Keiji,
Mitsuke Kazutaka,
Kamei Satoshi
Publication year - 2017
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12087
Subject(s) - medicine , meningitis , streptococcus pneumoniae , staphylococcus epidermidis , retrospective cohort study , penicillin , disease , antibiotics , group b , bacterial meningitis , staphylococcus aureus , pediatrics , microbiology and biotechnology , bacteria , biology , genetics
Background and Aim Therapeutic management of bacterial meningitis worldwide has been established based on the patient age and risk factors. Aim The present study investigated the distribution of pathogens and outcomes in adult bacterial meningitis with underlying disease in Tokyo, Japan. Methods Participants in this retrospective study were 131 adult cases diagnosed with having bacterial meningitis based on their clinical symptoms and laboratory data. All patients had been admitted to our hospitals (Nihon University Itabashi Hospital and Surugadai Hospital) in Tokyo, Japan, between 1984 and 2013. Bacterial meningitis was classified with underlying disease into three groups, as follows: group 1, invasive procedures or complicated head trauma within the preceding 3 months ( n = 35); group 2, immunocompromised status ( n = 37); or group 3, both conditions ( n = 31). Poor outcome was defined as a Glasgow Outcome Scale score of 1–3. Results The distribution of pathogens differed significantly in each group. The most common pathogen in each group was Staphylococcus epidermidis (23.7%) in group 1; penicillin‐intermediate Streptococcus pneumoniae (12.8%) in group 2; and Staphylococcus epidermidis (13.9%) in group 3. The highest rate of mortality and poor outcome was shown in group 2, and followed by group 3 and 1. The rate of antibiotic‐resistant bacteria was 68.9% for all pathogens in bacterial meningitis with underlying disease, 70.6% in group 1, 55.6% in group 2 and 80.6% in group 3. Conclusion This is the first retrospective study of the distribution of pathogens and outcomes in adult bacterial meningitis with underlying disease in Japan.