title: Pooled analysis of 899 nosocomial meningitis episodes from Turkey.
abstract: Healthcare-associated meningitis (HCAM) is a relatively rare entity with significant morbidity and mortality. The aim of this study was to systematically review the Turkish medical literature for acute nosocomial meningitis.
  
  
  
  One national (ULAKBİM) and two international (www.scopus.com and www.pubmed.com) databases were searched. In addition, abstracts of four national congresses held between 2004 and 2013 were searched for reports for HCAM meningitis.
  
  
  
  Data for 899 HCAM meningitis episodes were obtained from 24 reports. In terms of clinical findings, 177 of 216 (81.9%) had fever (>38 °C), 55 of 64 (85.9%) had high CRP levels, 105 of 132 had leukocytosis (>10,000/mm3), and 241 of 759 had shunt infection. Cerebrospinal fluid culture yielded a pathogen in 689 of 872 nosocomial meningitis episodes. The most common pathogen was Acinetobacter spp. (30.7%), followed by coagulase-negative staphylococci (21.2%) and Staphylococcus aureus (19%). Carbapenem resistance was reported in 18 of 48 (37.5%) Acinetobacter spp. Overall mortality was 160/593 (27%). Pathogen-specific mortality was 55.5% (30/54) for A. baumannii whereas it was 18.9% (7/37) for S. aureus and 2/17 (11,7%) for MRSA.
  
  
  
  Nosocomial meningitis is still a serious and highly fatal disease. More preventive measures should be sought to further decrease HCAM meningitis and the mortality/morbidity related to it.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Oğuz Reşat
authors.initials: OR
authors.lastname: Sipahi
authors.affiliation: Bilecik State Hospital, Bilecik, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Nazli Zeka
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Taşbakan
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Hüsnü
authors.initials: H
authors.lastname: Pullukçu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Bilgin
authors.initials: B
authors.lastname: Arda
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Tansu
authors.initials: T
authors.lastname: Yamazhan
authors.affiliation: Bornova District Directorate of Health, İzmir, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Sipahi
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Sercan
authors.initials: S
authors.lastname: Ulusoy
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D014421:Turkey / Q000453:epidemiology