Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea.
Epidemiologic data on the etiologic organisms is important for appropriate empirical antibiotic treatment of bacterial meningitis. We identified the etiologies of community-acquired bacterial meningitis in Korean adults and the associated epidemiological factors. A retrospective, multicenter nationwide study was carried out. Patients 18 years of age or older with community-acquired bacterial meningitis with a confirmed pathogen were enrolled. Demographic, clinical, and microbiological data were collected. One hundred and ninety-five cases were collected. Streptococcus pneumoniae was the most common pathogen (50.8%), followed by Staphylococcus aureus (10.3%), Klebsiella pneumoniae (7.7%), Listeria monocytogenes (6.7%), and group B Streptococcus (3.1%). The penicillin resistance rate of the S. pneumoniae was 60.3%; 40.0% of the organisms were not susceptible to third-generation cephalosporins. The combination of third-generation cephalosporin with vancomycin was used in 76.3% of cases. Steroids were given before or with the first dose of antibiotics in 37.4% of patients. The 30-day mortality rate was 20.5% and neurological sequelae developed in 15.6% of cases. S. pneumoniae was the most common organism identified in community-acquired bacterial meningitis among Korean adults. S. aureus, K. pneumoniae, L. monocytogenes, and group B Streptococcus were also common. S. pneumoniae had high rates of resistance to penicillin and third-generation cephalosporins.
Moon
S-Y
SY
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Chung
D R
DR
Kim
S-W
SW
Chang
H H
HH
Lee
H
H
Jung
D S
DS
Kim
Y-S
YS
Jung
S I
SI
Ryu
S Y
SY
Heo
S T
ST
Moon
C
C
Ki
H K
HK
Son
J S
JS
Kwon
K T
KT
Shin
S Y
SY
Lee
J S
JS
Lee
S S
SS
Rhee
J-Y
JY
Lee
J-A
JA
Joung
M K
MK
Cheong
H S
HS
Peck
K R
KR
Song
J-H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology; D017714:Community-Acquired Infections / Q000150:complications / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D008875:Middle Aged; D010403:Penicillin Resistance; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D014640:Vancomycin / Q000627:therapeutic use; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin