Mortality indicators in pneumococcal meningitis: therapeutic implications

被引：28

作者：

Erdem, Hakan ^{[1
]}

Elaldi, Nazif ^{[2
]}

Oztoprak, Nefise ^{[3
]}

Sengoz, Gonul ^{[4
]}

Ak, Oznur ^{[5
]}

Kaya, Selcuk ^{[6
]}

Inan, Asuman ^{[7
]}

Nayman-Alpat, Saygin ^{[8
]}

Ulu-Kilic, Aysegul ^{[9
]}

Pekok, Abdullah Umut ^{[10
]}

Gunduz, Alper ^{[11
]}

Gozel, Mustafa G. ^{[2
]}

Pehlivanoglu, Filiz ^{[4
]}

Yasar, Kadriye ^{[12
]}

Yilmaz, Hava ^{[13
]}

Hatipoglu, Mustafa ^{[1
]}

Cicek-Senturk, Gonul ^{[14
]}

Akcam, Fusun Z. ^{[15
]}

Inkaya, Ahmet C. ^{[16
]}

Kazak, Esra ^{[17
]}

Sagmak-Tartar, Ayse ^{[18
]}

Tekin, Recep ^{[19
]}

Ozturk-Engin, Derya ^{[7
]}

Ersoy, Yasemin ^{[20
]}

Sipahi, Oguz Resat ^{[21
]}

Guven, Tumer ^{[22
]}

Tuncer-Ertem, Gunay ^{[23
]}

Alabay, Selma ^{[9
]}

Akbulut, Ayhan ^{[18
]}

Balkan, Ilker I. ^{[24
]}

Oncul, Oral ^{[1
]}

Cetin, Birsen ^{[25
]}

Dayan, Saim ^{[19
]}

Ersoz, Gulden ^{[26
]}

Karakas, Ahmet ^{[27
]}

Ozgunes, Nail ^{[28
]}

Sener, Alper ^{[29
]}

Yesilkaya, Aysegul ^{[30
]}

Erturk, Ayse ^{[31
]}

Gundes, Sibel ^{[32
]}

Karabay, Oguz ^{[33
]}

Sirmatel, Fatma ^{[34
]}

Tosun, Selma ^{[35
]}

Turhan, Vedat ^{[1
]}

Yalci, Aysun ^{[36
]}

Akkoyunlu, Yasemin ^{[37
]}

Aydin, Emsal ^{[38
]}

Diktas, Husrev ^{[39
]}

Kose, Sukran ^{[40
]}

Ulcay, Asim ^{[1
]}

机构：

[1] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[2] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey

[3] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey

[4] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[5] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[6] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey

[7] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[8] Osmangazi Univ Sch Med, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey

[9] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey

[10] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey

[11] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[12] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[13] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey

[14] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey

[15] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey

[16] Hacettepe Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey

[17] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey

[18] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey

[19] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey

[20] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey

[21] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[22] Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey

[23] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey

[24] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[25] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[26] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey

[27] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey

[28] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[29] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey

[30] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06490 Ankara, Turkey

[31] Recep Tayyip Erdogan Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Rize, Turkey

[32] Kocaeli Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Izmit, Turkey

[33] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey

[34] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey

[35] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[36] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey

[37] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[38] Kafkas Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kars, Turkey

[39] Mil Hosp, Dept Infect Dis & Clin Microbiol, Tatvan, Turkey

[40] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

来源：

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES | 2014年 / 19卷

关键词：

Streptococcus pneumoniae; Meningitis; Mortality; Penicillin; Resistance; Vancomycin; ACUTE BACTERIAL-MENINGITIS; RESISTANT STREPTOCOCCUS-PNEUMONIAE; POST-NEUROSURGICAL MENINGITIS; PENICILLIN RESISTANCE; ANTIBIOTIC-RESISTANCE; UNITED-STATES; VANCOMYCIN; DAPTOMYCIN; BINDING; CEFTRIAXONE;

D O I：

10.1016/j.ijid.2013.09.012

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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.

引用

页码：13 / 19

页数：7

共 51 条

[1] Pharmacodynamics of vancomycin for the treatment of experimental penicillin- and cephalosporin-resistant pneumococcal meningitis [J].

Ahmed, A ;

Jafri, H ;

Lutsar, I ;

McCoig, CC ;

Trujillo, M ;

Wubbel, L ;

Shelton, S ;

McCracken, GH .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1999, 43 (04) :876-881

[2]

Aslan G, 2012, MIKROBIYOL BUL, V46, P190

[3] GENETICS OF HIGH-LEVEL PENICILLIN RESISTANCE IN CLINICAL ISOLATES OF STREPTOCOCCUS-PNEUMONIAE [J].

BARCUS, VA ;

GHANEKAR, K ;

YEO, M ;

COFFEY, TJ ;

DOWSON, CG .

FEMS MICROBIOLOGY LETTERS, 1995, 126 (03) :299-303

[4] Attenuation of cognitive impairment by the nonbacteriolytic antibiotic daptomycin in Wistar rats submitted to pneumococcal meningitis [J].

Barichello, Tatiana ;

Nepomuceno Goncalves, Joao Carlos ;

Generoso, Jaqueline S. ;

Milioli, Graziele L. ;

Silvestre, Cintia ;

Costa, Caroline S. ;

Coelho, Jaqueline da Rosa ;

Comim, Clarissa M. ;

Quevedo, Joao .

BMC NEUROSCIENCE, 2013, 14

[5] Pharmacokinetics and tolerability of daptomycin at doses up to 12 milligrams per kilogram of body weight once daily in healthy volunteers [J].

Benvenuto, Mark ;

Benziger, David P. ;

Yankelev, Sara ;

Vigliani, Gloria .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2006, 50 (10) :3245-3249

[6] Antimicrobial Susceptibility among Gram-Positive Organisms Collected from Pediatric Patients Globally between 2004 and 2011: Results from the Tigecycline Evaluation and Surveillance Trial [J].

Brandon, Michael ;

Dowzicky, Michael J. .

JOURNAL OF CLINICAL MICROBIOLOGY, 2013, 51 (07) :2371-2378

[7]

Celal Ayaz, 2004, Indian J Med Sci, V58, P327

[8] Clinical implication of extended-spectrum cephalosporin nonsusceptibility in Streptococcus pneumoniae meningitis [J].

Choi, S. -H. ;

Chung, J. -W. ;

Kim, B. -N. ;

Kwak, Y. G. ;

Kim, T. H. ;

Lee, E. J. ;

Choo, E. J. ;

Jeon, M. -H. ;

Lee, M. S. ;

Bae, I. -G. ;

Lee, S. -R. ;

Song, E. H. ;

Jun, J. -B. ;

Kim, M. -N. ;

Kim, S. -H. ;

Lee, S. -O. ;

Kim, Y. S. ;

Woo, J. H. ;

Choi, S. H. .

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2012, 31 (11) :3029-3034

[9]

Clinical and Laboratory Standards Institute, 2012, M100S22 CLSI

[10] Daptomycin is highly efficacious against penicillin-resistant and penicillin- and quinolone-resistant pneumococci in experimental meningitis [J].

Cottagnoud, P ;

Pfister, M ;

Acosta, F ;

Cottagnoud, M ;

Flatz, L ;

Kühn, F ;

Müller, HP ;

Stucki, A .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2004, 48 (10) :3928-3933

← 1 2 3 4 5 6 →