title: Clinical characteristics of post-neurosurgical Klebsiella pneumoniae meningitis in adults and a clinical comparison to the spontaneous form in a Taiwanese population.
abstract: A total of 46 patients (nine post-neurosurgical, 37 spontaneous) with adult bacterial meningitis (ABM) caused by Klebsiellapneumoniae infection were included in this study. The nine patients in the post-neurosurgical K. pneumoniae ABM group (seven male, two female) had a mean age of 48.9 years. Two patients in this group also had diabetes mellitus (DM) and one had liver disease. The most common presentation of patients in post-neurosurgical K. pneumoniae ABM group was fever (nine patients), followed by altered consciousness (seven patients) and hydrocephalus (six patients). With medical and/or surgical treatment, a mortality of 22.2% (2/9) occurred. Compared to patients who had spontaneous K. pneumoniae ABM, those with the post-neurosurgical form had a lower incidence of community-acquired infection, seizure and DM, but had a higher incidence of leukocytosis, hydrocephalus, cerebrospinal fluid leak and bacterial strains with extended-spectrum beta-lactamase. Univariate analysis found these clinical differences to be statistically significant, however they were not significant on multivariate analysis. This study reveals that there are clinical differences between the post-neurosurgical and spontaneous presentations of K. pneumoniae ABM.
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Centre, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung County, Taiwan. cwenneng@ms19.hinet.net
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.forename: Chen-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Chi-Ren
authors.initials: CR
authors.lastname: Huang
authors.forename: Yao-Chung
authors.initials: YC
authors.lastname: Chuang
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Tsai
authors.forename: Chiung-Chih
authors.initials: CC
authors.lastname: Chang
authors.forename: Shu-Fang
authors.initials: SF
authors.lastname: Chen
authors.forename: Hung-Chen
authors.initials: HC
authors.lastname: Wang
authors.forename: Tzu-Ming
authors.initials: TM
authors.lastname: Yang
authors.forename: Mei-Jen
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Chien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000382:microbiology* / Q000503:physiopathology*; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult