title: Bacterial meningitis in diabetes patients: a population-based prospective study.
abstract: Diabetes mellitus is associated with increased infection rates. We studied clinical features and outcome of community-acquired bacterial meningitis in diabetes patients. Patients were selected from a nationwide, prospective cohort on community-acquired bacterial meningitis performed from March 2006 to October 2014. Data on patient history, symptoms and signs on admission, treatment, and outcome were prospectively collected. A total of 183 of 1447 episodes (13%) occurred in diabetes patients. The incidence of bacterial meningitis in diabetes patients was 3.15 per 100,000 patients per year and the risk of acquiring bacterial meningitis was 2.2-fold higher for diabetes patients. S. pneumoniae was the causative organism in 139 of 183 episodes (76%) and L. monocytogenes in 11 of 183 episodes (6%). Outcome was unfavourable in 82 of 183 episodes (45%) and in 43 of 183 episodes (23%) the patient died. Diabetes was associated with death with an odds ratio of 1.63 (95% CI 1.12-2.37, P = 0.011), which remained after adjusting for known predictors of death in a multivariable analysis (OR 1.98 [95% CI 1.13-3.48], P = 0.017). In conclusion, diabetes is associated with a 2-fold higher risk of acquiring bacterial meningitis. Diabetes is a strong independent risk factor for death in community-acquired adult bacterial meningitis.
authors.affiliation: Department of Neurology, Amserdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.|Department of Neurology, Medical Center Haaglanden, The Hague, the Netherlands.
authors.forename: Kiril E B
authors.initials: KE
authors.lastname: van Veen
authors.affiliation: Department of Neurology, Amserdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Matthijs C
authors.initials: MC
authors.lastname: Brouwer
authors.affiliation: The Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Arie
authors.initials: A
authors.lastname: van der Ende
authors.affiliation: Department of Neurology, Amserdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Diederik
authors.initials: D
authors.lastname: van de Beek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008089:Listeria monocytogenes; D008088:Listeriosis / Q000453:epidemiology*; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology*; D011446:Prospective Studies; D013296:Streptococcus pneumoniae