Epidemiology and clinical characteristics of Klebsiella spp. meningitis in France
| Autor: | A. Le Monnier, Anaïs Potron, V. Fihman, Eric Farfour, A-G Ranc, Nicolas Degand, J-R Zahar, Olivier Barraud, Emmanuelle Bille, Benoit Pilmis, Laurent Dortet, G Héry-Arnaud, Philippe Morand, G. Pean de Ponfilly, L. Ruffier d’Epenoux, F Laurent, C. Le Brun, C. Piau, Thomas Guillard, Assaf Mizrahi |
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| Přispěvatelé: | Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cirrhosis CSF glucose Klebsiella pneumoniae medicine.drug_class [SDV]Life Sciences [q-bio] Cephalosporin Neurological disorder Meningitis Bacterial 03 medical and health sciences 0302 clinical medicine Internal medicine Klebsiella Epidemiology medicine Humans 030212 general & internal medicine ComputingMilieux_MISCELLANEOUS Retrospective Studies 0303 health sciences biology 030306 microbiology business.industry Mortality rate biology.organism_classification medicine.disease 3. Good health Klebsiella Infections Infectious Diseases France business Meningitis |
| Zdroj: | Infectious Diseases Now Infectious Diseases Now, Elsevier, 2021, ⟨10.1016/j.idnow.2021.05.006⟩ |
| ISSN: | 2666-9919 |
| DOI: | 10.1016/j.idnow.2021.05.006⟩ |
| Popis: | Objectives. To describe the epidemiology of Klebsiella spp. meningitis in France with respect to clinical and bacteriological data. Methods. We performed a four-year multicenter, retrospective, observational study. The primary objective was to provide a clinical description of patients with Klebsiella spp. meningitis. Secondary objectives were to compare community-acquired meningitis and healthcare-associated meningitis and to analyze factors associated with mortality. Results. We enrolled 131 patients with Klebsiella spp. meningitis. Eighty-two (62.6%) infections were reported following neurosurgery. Twenty-eight strains (21.4%) were resistant to third-generation cephalosporins (3GC). The median [IQR] cellularity was 980/mm3 [116-5,550], the median protein level was 5.67 [1.62-9] g/L and the median CSF glucose level was 2.5 [0-3.4] mmol/L. The in-hospital mortality rate was 23.6%. Community-acquired meningitis isolates were more frequently susceptible to 3GC than isolates from healthcare-associated meningitis (89.2% versus 72%; p=0.04). Comorbidities reported for patients with community-acquired meningitis were mainly diabetes mellitus and liver cirrhosis. In multivariate analysis, focal neurological disorder at the time of diagnosis was the only factor associated with in-hospital mortality (p=0.01). Conclusions. Purulent meningitis caused by Klebsiella spp. needs to be considered in patients with community-acquired meningitis and pre-existing conditions, as well as in case of meningitis following neurosurgical procedures. |
| Databáze: | OpenAIRE |
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