Adult Pseudomonas aeruginosa meningitis: high incidence of underlying medical and/or postneurosurgical conditions and high mortality rate.
We analyzed the clinical and laboratory characteristics, therapeutic outcome and prognostic factors of 25 cases of cerebrospinal fluid (CSF) culture-proven Pseudomonas aeruginosa adult bacterial meningitis (ABM). Twelve P. aeruginosa strains, isolated from clinical CSF specimens, were tested for antibiotic susceptibility. The 25 cases included 17 men and 8 women, aged 17 to 86 years (median=51). Of the 25 cases of P. aeruginosa ABM, 18 were the result of postneurosurgical infection and the other 7 were spontaneous infections. The latter 7 cases had serious underlying medical conditions. The antibiotic susceptibility rates of the 12 strains were as follows: ceftriaxone 16.7% (2/12), ceftazidime 91.7% (11/12), cefepime 83.3% (10/12), imipenem 83.3% (10/12), meropenem 83.3% (10/12) and ciprofloxacin 66.7% (8/12). The therapeutic results showed an overall mortality rate of 40% (10/25). The emergence of third-generation cephalosporin-resistant P. aeruginosa strains cultured from clinical CSF specimens in recent years has resulted in a therapeutic challenge in the treatment of ABM.
Huang
C R
CR
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Lu
C H
CH
Chuang
Y C
YC
Tsai
N W
NW
Chang
C C
CC
Chen
S F
SF
Wang
H C
HC
Chien
C C
CC
Chang
W N
WN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents