In our case report, investigations were performed to identify the source of p. In addition, metastatic infection from hospitalacquired bacteremia occasionally leads to meningitis. In a recent epidemiological study of bacterial meningitis in the united. The causes and treatment outcomes of 91 patients with adult. Bacterial meningitis occurs in about 3 people per 100,000 annually in western countries. Nosocomial bacterial meningitis is most often related to either complicated head trauma or invasive procedures, such as craniotomy, placement of ventricular catheters, intrathecal infusion of medications, or spinal anesthesia.
Pdf nosocomial bacterial meningitis is most often related to either. Paediatric bacterial meningitis is a neurological emergency which, despite advances in medical management, still has a significant morbidity and mortality. Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in. The latter group has often been classified as nosocomial meningitis. Superinfection in adult bacterial meningitis abm is a condition in which the cerebrospinal fluid csf grows new pathogens during the therapeutic course of meningitis 1, 2. Nosocomial bacterial meningitis is most often related to either complicated head trauma or invasive procedures, such as craniotomy, placement of ventricular catheters, intrathecal infusion of. This website provides free medical books this website provides over 0 free medical books and more for all students and doctors this website the best choice for medical students during and after learning medicine. Clinical characteristics and therapeutic outcomes of. Hospitalacquired meningitis is rapidly increasing and adding an immense burden to the health system due to the emergence of multidrug resistance isolates.
A major complication of this procedure is an evdrelated venticulitis or meningitis. Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. Among the various types of hospitalacquired infections, bacterial meningitis is the most severe. There were 267 cases, in patients 16 years of age or older, with cultureproven bacterial meningitis, of which 73 appeared in the first time period, and 194 in the second. Some data point to a potential benefit of ivit antibiotic treatment, mainly. In abm management, early and appropriate antibiotic use is an important strategy for better outcomes 57. Nosocomial bacterial meningitis prevention rather than cure. Nosocomial infection increases hospital stay and medical costs. Communityacquired bacterial meningitis in adults with. Complications occurred in 50% of the episodes and 16% of the patients died.
Chapter 6 duration of treatment before csf catheter replacement. The type of treatment depends on the germ that caused the meningitis. This bacterium is the most common cause of bacterial meningitis in infants, young children and adults in the united states. Diagnosis, initial management, and prevention of meningitis. Patients with healthcareassociated meningitis or ventriculitis tend to have poor clinical outcomes, which could be attributable to both underlying neurological diseases and superimposed nosocomial infections. What are cerebrospinal fluid csf characteristics in. Nosocomial meningitis caused by gas producing klebsiella. External ventricular drainage evd is frequently necessary in neurological and neurosurgical intensive care patients. Populationwide studies have shown that viral meningitis is more common, at 10. Characteristics of nosocomial bacterial meningitis in children. The diagnosis of cryptococcal meningitis relies on the identification of the pathogen in the csf. The purpose of this study is to find the antibiotic susceptibility pattern of the bacteria detected from hospital and communityacquired meningitis. Mixed bacterial infection with more than one agent typically accounts for 1% of all cases of abm and is seen in patients who are immunosuppressed, have skull.
This bacterium is another leading cause of bacterial meningitis. All patients with bacterial meningitis and many with viral meningitis will be treated in the hospital. Nosocomial bacterial meningitis is most often related to either complicated head trauma or invasive procedures, such as craniotomy, placement of ventricular catheters, intrathecal infusion of medic. Epidemiology of bacterial meningitis in the usa from 1997 to 2010. Nosocomial definition of nosocomial by medical dictionary. Prophylactic antibiotics appear to reduce the rate of postcraniotomy meningitis often caused by s. This nosocomial infection affects patients differently with symptoms ranging from mild to severe. This was a case of nosocomial meningitis because the bacteria was identified in a csf analysis performed more than 48 h after the hospitalization, but the. In most cases washing the hands after each patient contact is the most effective way.
For this populationbased observational study, we searched information available from hospital discharges about incidence and inpatient mortality for the most important causes of community and nosocomial bacterial meningitis based on international classification of diseases coding across all hospitals in the usa between 1997 and 2010 with the healthcare cost utilization project hcup. Nosocomial bacterial meningitis can be caused by in vasive procedures e. Diagnosis and management of bacterial meningitis in the. Practice guidelines for acute bacterial meningitidis. Bacterial meningitis in adults research explorer universiteit van. The aim of this study was to assess the potential role of decoy receptor 3 dcr3 levels in the differentiation of bacterial meningitis from nonbacterial meningitis. Our study confirms that adults with nosocomial bacterial meningitis are a distinct patient group with specific bacterial pathogens, as compared to those with communityacquired meningitis.
Nosocomial bacterial meningitis may result from invasive procedures for examples, such as craniotomies, the placement of internal or external ventricular catheters, lumbar puncture, intrathecal infusions of medications, or spinal anesthesia, head trauma, or hospitalacquired bacteremia complicated by metastatic infection. Nosocomial bacterial meningitis is uncommon in children, accounting for only 0. Pdf nosocomial bacterial meningitis prevention rather. Of these 267 cases, 62 were identified as having postneurosurgical nosocomial bacterial meningitis and were therefore included in this study. Infections of the central nervous system cns can be divided into 2 broad categories. The specific bacteria that cause nosocomial meningitis vary according to the pathogenesis and timing of infection after the predisposing event, so the choice of. The causes and treatment outcomes of 91 patients with. Nosocomial meningitis, current infectious disease reports. Defining bacterial meningitis and other infections of the. For example, clostridium, which are anaerobic grampositive rods causing gangrene. In general, there are no medications to fight the germs that cause viral meningitis, so. Impact of nosocomial infections hospitalacquired infections add to. Nosocomial ventriculitis and meningitis in neurocritical. Nosocomial bacterial meningitis caused by k pneumoniae can present with intracranial gas on cranial imaging.
Bacteria are the most common nosocomial infections in hospitalised patients. A number of studies have evaluated the prevalence of different organisms that cause bacterial meningitis. Nosocomial bacterial meningitis may result from invasive procedures. Despite the availability of antimicrobial therapy, meningitisrelated case fatality rates remain high, with a 17% allcause mortality rate between 1980 and 1988 reported for communityacquired and nosocomial bacterial meningitis among patients aged 16 years and older.
Article pdf available in journal of the pakistan medical association 637. Meningitis is an inflammation of the tissue that covers the brain and spinal cord that can be caused by several different types of, as well as viruses and fungibacteria. Some of the most common causes of bacterial meningitis include neisseria meningitidis, streptococcus. Recommended empirical antimicrobial therapy for nosocomial bacterial. Acute bacterial meningitis in adults pdf free download. Grampositive pathogens such as methicillinresistant coagulasenegative staphylococcus mrcns are the main target organisms to. Nosocomial meningitis nosocomial meningitis bleck, thomas 20070417 00. Clostridium difficile infection is a bacterial infection which affects the digestive system.
Infection rates are higher among patients with increased susceptibility because of old age, underlying disease, or chemotherapy. Acute bacterial meningitis continues to be a potentially life threatening condition. Nosocomial bacterial meningitis and csf shunt infections result in considerable morbidity and mortality, necessitating an organized and thoughtful approach to prevention, diagnosis, and management. Epidemiology of bacterial meningitis in the usa from 1997. Postneurosurgical nosocomial bacterial meningitis in. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Nosocomial bacterial meningitis requires timely treatment, but what is difficult is the prompt and accurate diagnosis of this disease. The discussion of the dose, method of infusion, and determination of subsequent doses of intraventricular vancomycin and gentamicin is particularly well done, as is the discussion of the indications for ventricularcatheter removal in the setting of meningitis and the. Our study confirms that adults with nosocomial meningitis are a distinct patient group with specific bacterial pathogens, as compared to those with communityacquired bacterial meningitis.
Request pdf nosocomial bacterial meningitis in adults. Epidemiology, diagnosis and antimicrobial treatment of acute bacterial meningitis. Gramnegative ventriculitis tends to have high mortality rates. It more commonly causes pneumonia or ear or sinus infections. Acute community acquired bacterial meningitis flashcards. Bacterial meningitis in patients with csf leakage can be classified as community acquired, in case of anatomic defects or contiguous spread of infection, or nosocomial or healthcareassociated meningitis after surgery for trauma 5, 7, 8. Over recent decades new vaccines have led to a change in epidemiology of the disease. Start studying acute community acquired bacterial meningitis. More than one third of all such infections are easily preventable without sophisticated and expensive equipment or procedures. It can be acquired spontaneously in the community communityacquired bacterial meningitis or in the hospital as a complication of invasive procedures or head trauma nosocomial bacterial. The abrupt onset of typical signs and symptoms of acute bacterial meningitis in someone with a previously normal mental status is very unusual, and when it occurs, it does not pose a diagnostic. Nosocomial bacterial and fungal meningitis in cancer patients.
Nosocomial bacterial meningitis can be caused by invasive procedures e. Communityacquired bacterial meningitis request pdf. Staphylococcus aureus meningitis is a challenging disease and little is known about its epidemiology. The information was formulated into a proposed standard for definite, probable, and. In brazil, the rate of bacterial meningitis is higher, at 45. This uncommon situation is rarely examined solely in overview studies of abm 3, 4.