Clinical characteristics of post-neurosurgical Klebsiella pneumoniae meningitis in adults and a clinical comparison to the spontaneous form in a Taiwanese population.
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.
Chang
Wen-Neng
WN
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Centre, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung County, Taiwan. cwenneng@ms19.hinet.net
Lu
Chen-Hsien
CH
Huang
Chi-Ren
CR
Chuang
Yao-Chung
YC
Tsai
Nai-Wen
NW
Chang
Chiung-Chih
CC
Chen
Shu-Fang
SF
Wang
Hung-Chen
HC
Yang
Tzu-Ming
TM
Hsieh
Mei-Jen
MJ
Chien
Chun-Chih
CC
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