Klebsiella meningitis in adults: clinical features, prognostic factors and therapeutic outcomes.
Sixty adult Klebsiella meningitis patients have been identified at Kaohsiung Chang Gung Memorial Hospital in a period of 13 years. Most cases were associated with debilitating diseases, and devastating metastatic septic abscesses are common in diabetic patients with K. pneumoniae meningitis. Although the mortality rate has been significantly reduced in recent years, there has been an increase in nosocomial infections and the emergence of multi-antibiotic resistant strains. Significant prognostic factors include appropriate antibiotic therapy, the presence of septic shock, disseminated intravascular coagulation, and high cerebrospinal fluid protein levels and white blood cell counts. Initial empiric therapy with a third generation cephalosporin should be considered for community-acquired meningitis while antibiotics such as carbapenems should be considered as initial empiric therapy for patients with postneurosurgical meningitis. Early diagnosis and the use of appropriate antibiotics are of crucial importance.
Lu
Cheng-Hsien
CH
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan. chlu99@ms44.url.com.tw
Chang
Wen-Neng
WN
Chang
Hsueh-Wen
HW
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000134:cerebrospinal fluid / Q000382:microbiology / Q000628:therapy; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007709:Klebsiella / Q000187:drug effects; D007710:Klebsiella Infections / Q000134:cerebrospinal fluid / Q000382:microbiology / Q000628:therapy*; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000382:microbiology / Q000628:therapy*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011183:Postoperative Complications / Q000134:cerebrospinal fluid / Q000382:microbiology; D011379:Prognosis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents