Mortality Indicators In Pneumococcal Meningitis: Therapeutic Implications

Autor: Mustafa Gökhan Gözel, Füsun Zeynep Akçam, Nefise Oztoprak, Asim Ulcay, Derya Ozturk-Engin, Gonul Sengoz, Gunay Tuncer-Ertem, Saygin Nayman-Alpat, Yasemin Ersoy, Gülden Ersöz, Nazif Elaldi, Ayse Sagmak-Tartar, Oğuz Reşat Sipahi, Selçuk Kaya, Recep Tekin, Emsal Aydin, Hava Yilmaz, Nail Ozgunes, Alper Şener, Sibel Gundes, Ayşegül Yeşilkaya, Tumer Guven, Hakan Erdem, Birsen Cetin, Derya Seyman, Vedat Turhan, Oznur Ak, Kadriye Kart Yaşar, Ahmet Karakaş, Oral Oncul, Ahmet Çağkan İnkaya, Gonul Cicek-Senturk, Yasemin Akkoyunlu, Oguz Karabay, Hakan Leblebicioglu, Ilker Inanc Balkan, Aysegul Ulu-Kilic, Mustafa Hatipoglu, Aysun Yalci, Husrev Diktas, Ayşe Ertürk, Filiz Pehlivanoglu, Selma Alabay, Asuman Inan, Umit Savasci, Alper Gunduz, Ayhan Akbulut, Fatma Sirmatel, Haluk Vahaboglu, Esra Kazak, Saim Dayan, Sukran Kose, Selma Tosun, Abdullah Umut Pekok
Přispěvatelé: İç Hastalıkları, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Sırmatel, Fatma, [Erdem, Hakan -- Hatipoglu, Mustafa -- Oncul, Oral -- Turhan, Vedat -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, Nazif -- Gozel, Mustafa G.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Oztoprak, Nefise -- Seyman, Derya] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ak, Oznur] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kaya, Selcuk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Nayman-Alpat, Saygin] Osmangazi Univ Sch Med, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Ulu-Kilic, Aysegul -- Alabay, Selma] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Pekok, Abdullah Umut] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Gunduz, Alper] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Hava -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Cicek-Senturk, Gonul] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Akcam, Fusun Z.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Inkaya, Ahmet C.] Hacettepe Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Kazak, Esra] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Sagmak-Tartar, Ayse -- Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sipahi, Oguz Resat] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guven, Tumer] Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Tuncer-Ertem, Gunay] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Balkan, Ilker I.] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoz, Gulden] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Karakas, Ahmet] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ozgunes, Nail -- Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Yesilkaya, Aysegul] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06490 Ankara, Turkey -- [Erturk, Ayse] Recep Tayyip Erdogan Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Rize, Turkey -- [Gundes, Sibel] Kocaeli Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Izmit, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yalci, Aysun] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Akkoyunlu, Yasemin] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Aydin, Emsal] Kafkas Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Diktas, Husrev] Mil Hosp, Dept Infect Dis & Clin Microbiol, Tatvan, Turkey -- [Kose, Sukran -- Savasci, Umit] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- Dept Infect Dis & Clin Microbiol, Sarikamis Mil Hosp, Kars, Turkey, Yesilkaya, Aysegul -- 0000-0003-0225-6416, Leblebicioglu, Hakan -- 0000-0002-6033-8543, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Elaldi, Nazif -- 0000-0002-9515-770X, Gozel, Mustafa Gokhan -- 0000-0001-5187-7388, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Karakas, Ahmet -- 0000-0002-0553-8454, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, hatipoglu, mustafa -- 0000-0001-9910-1650, Gunduz, Alper -- 0000-0001-9154-844X, HATİBOĞLU, MUSTAFA AZİZ, Ege Üniversitesi, OMÜ
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Popis: WOS: 000329981700003
PubMed ID: 24211227
Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.
Databáze: OpenAIRE
Externí odkaz: