[Posttraumatic meningitis: incidence, bacteriology, and outcomes].
OBJECTIVE
The aim of our study was to search for the incidence, the responsible organisms and the favoring causes of death of post-traumatic meningitis (PTM).


METHODS
This retrospective study was conducted over a seven-year period (January 1st, 1996 - December 31, 2002) in the ICU and the neurosurgery department of the Habib-Bourguiba University Hospital, Sfax, Tunisia.


RESULTS
Over the study period, 38 patients presented PTM (0.96% of patients hospitalized for head injury), 92% of them had received antibiotic prophylaxis on admission. Mean time between head injury and the diagnosis of PTM was 9+/- 8 days (range: 2-34 days). The most common isolated organisms were multidrug resistant A. baumanii, and K. pneumoniae and reduced susceptibility S. pneumoniae. Factors predictive of prognosis in the 14 days following the diagnosis of meningitis were Glasgow coma score (GCS) on the day of diagnosis of PTM, absence of nuchal rigidity, CSF protein, CSF/blood glucose ratio, and S. pneumoniae as the causal agent of PTM.


CONCLUSIONS
Antibioprophylaxis in patients with head trauma must be avoided to prevent the emergence of multidrug resistant bacteria when PTM occurs. GCS on the day of diagnosis of PTM, CSF protein concentration, CSF/blood glucose ratio, and S. pneumoniae as the causal agent of PTM are predictive factors of mortality of patients with PTM.
Kallel
H
H
Service de Réanimation Médicale, CHU Habib-Bourguiba, route El-Aïn, km 1, 3029 Sfax, Tunisie. Kallelhat@yahoo.fr
Chelly
H
H
Ghorbel
M
M
Bahloul
M
M
Ksibi
H
H
Rekik
N
N
Ben Mansour
H
H
Bouaziz
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D002423:Cause of Death; D002556:Cerebrospinal Fluid Proteins / Q000097:blood; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000401:mortality*; D024881:Drug Resistance, Bacterial; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000209:etiology* / Q000382:microbiology / Q000401:mortality*; D008586:Meningitis, Pneumococcal / Q000401:mortality; D008875:Middle Aged; D009127:Muscle Rigidity / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D016019:Survival Analysis; D009626:Terminology as Topic; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D001786:Blood Glucose; D002556:Cerebrospinal Fluid Proteins