title: Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Moon
authors.forename: D R
authors.initials: DR
authors.lastname: Chung
authors.forename: S-W
authors.initials: SW
authors.lastname: Kim
authors.forename: H H
authors.initials: HH
authors.lastname: Chang
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.forename: D S
authors.initials: DS
authors.lastname: Jung
authors.forename: Y-S
authors.initials: YS
authors.lastname: Kim
authors.forename: S I
authors.initials: SI
authors.lastname: Jung
authors.forename: S Y
authors.initials: SY
authors.lastname: Ryu
authors.forename: S T
authors.initials: ST
authors.lastname: Heo
authors.forename: C
authors.initials: C
authors.lastname: Moon
authors.forename: H K
authors.initials: HK
authors.lastname: Ki
authors.forename: J S
authors.initials: JS
authors.lastname: Son
authors.forename: K T
authors.initials: KT
authors.lastname: Kwon
authors.forename: S Y
authors.initials: SY
authors.lastname: Shin
authors.forename: J S
authors.initials: JS
authors.lastname: Lee
authors.forename: S S
authors.initials: SS
authors.lastname: Lee
authors.forename: J-Y
authors.initials: JY
authors.lastname: Rhee
authors.forename: J-A
authors.initials: JA
authors.lastname: Lee
authors.forename: M K
authors.initials: MK
authors.lastname: Joung
authors.forename: H S
authors.initials: HS
authors.lastname: Cheong
authors.forename: K R
authors.initials: KR
authors.lastname: Peck
authors.forename: J-H
authors.initials: JH
authors.lastname: Song
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin