- Infection
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Nosocomial meningitis in intensive care: a 10-year retrospective study and literature review
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Sofia R. Valdoleiros, Cristina Torrão, Laura S. Freitas, Diana Mano, Celina Gonçalves, Carla Teixeira
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Acute Crit Care. 2022;37(1):61-70. Published online January 26, 2022
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DOI: https://doi.org/10.4266/acc.2021.01151
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Abstract
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- Background
Nosocomial meningitis is a medical emergency that requires early diagnosis, prompt initiation of therapy, and frequent admission to the intensive care unit (ICU).
Methods A retrospective study was conducted in adult patients diagnosed with nosocomial meningitis who required admission to the ICU between April 2010 and March 2020. Meningitis/ventriculitis and intracranial infection were defined according to Centers for Disease Control and Prevention guidelines.
Results An incidence of 0.75% of nosocomial meningitis was observed among 70 patients. The mean patient age was 59 years and 34% were ≥65 years. Twenty-two percent of patients were in an immunocompromised state. A clear predisposing factor for nosocomial meningitis (traumatic brain injury, basal skull fracture, brain hemorrhage, central nervous system [CNS] invasive procedure or device) was present in 93% of patients. Fever was the most frequent clinical feature. A microbiological agent was identified in 30% of cases, of which 27% were bacteria, with a predominance of Gram-negative over Gram-positive. Complications developed in 47% of cases, 24% of patients were discharged with a Glasgow coma scale <14, and 37% died. There were no clear clinical predictors of complications. Advanced age (≥65 years old) and the presence of complications were associated with higher hospital mortality.
Conclusions Nosocomial meningitis in critical care has a low incidence rate but high mortality and morbidity. In critical care patients with CNS-related risk factors, a high level of suspicion for meningitis is warranted, but diagnosis can be hindered by several confounding factors.
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Citations
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Hazem E. Mohammed, Mohamed Nasser, Moaz Elsayed Abouelmagd, Mohamed E. Haseeb, Mohamed Khalafalla Darwish, Mohamed Salem Abdelqader, Ahmed Tawfik, Rania Elsayed Mahmoud Abdel-Mawla, Mahmoud Diaa Hindawi Clinical Neurology and Neurosurgery.2025; 249: 108767. CrossRef - Procalcitonin As Diagnostic Tool for CNS Infections—Overall, Not Good Enough (Yet?)*
Michael A. Pizzi, Katharina M. Busl Critical Care Medicine.2024; 52(1): 163. CrossRef - A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020
Joseph Donovan, Abena Glover, John Gregson, Andrew W. Hitchings, Emma C. Wall, Robert S. Heyderman BMC Infectious Diseases.2024;[Epub] CrossRef - Clinical Characteristics, Treatment, and Outcomes of Veterans with Cerebrospinal Fluid Culture Positive for Gram-Negative Rod Bacteria: A Retrospective Analysis over 18 Years in 125 Veterans Health Administration Hospitals
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Sakke Niemelä, Laura Lempinen, Eliisa Löyttyniemi, Jarmo Oksi, Jussi Jero BMC Infectious Diseases.2023;[Epub] CrossRef - Bacterial meningitis in children with an abnormal craniocerebral structure
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Hana Panic, Branimir Gjurasin, Marija Santini, Marko Kutlesa, Neven Papic Infectious Disease Reports.2022; 14(3): 420. CrossRef - Healthcare-associated central nervous system infections
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