Epidemiology and clinical characteristics of Klebsiella spp. meningitis in France

被引:4
作者
Pilmis, B. [1 ,2 ,3 ,4 ]
de Ponfilly, G. Pean [2 ,3 ,5 ]
Farfour, E. [6 ]
Ranc, A-G [7 ]
Fihman, V [8 ]
Bille, E. [9 ]
Dortet, L. [10 ]
Degand, N. [11 ]
Morand, P. [12 ]
Potron, A. [13 ]
Mizrahi, A. [2 ,3 ,14 ]
Laurent, F. [6 ]
Le Brun, C. [15 ]
Guillard, T. [16 ]
Hery-Arnaud, G. [17 ]
Piau, C. [18 ]
Barraud, O. [19 ]
D'Epenoux, L. Ruffier [20 ]
Zahar, J-R [21 ]
Le Monnier, A. [2 ,3 ,5 ]
机构
[1] Grp Hosp Paris St Joseph, Equipe Mobile Microbiol Clin, 185 Rue Raymond Losserand, F-75014 Paris, France
[2] Univ Paris Saclay, AgroParisTech, INRAe, Inst Micalis UMR 1319, Chatenay Malabry, France
[3] GH Paris St Joseph, Serv Microbiol Clin, F-75014 Paris, France
[4] Hop Necker Enfants Malad, Serv Malad Infect & Trop, Paris, France
[5] CHU St Louis Lariboisiere Fernand Widal, AP HP, Dept Agents Infectieux, Lab Bacteriol, F-75010 Paris, France
[6] Hop Foch, Serv Biol Clin, F-92150 Suresnes, France
[7] Hosp Civils Lyon, Inst Agents Infectieux IAI, Lyon, France
[8] Grp Hosp Henri Mondor, Unite Bacteriol, F-94010 Creteil, France
[9] Hop Necker Enfants Malad, Lab Microbiol, F-75015 Paris, France
[10] CHU Bicetre, Serv Bacteriol Hyg, F-94270 Le Kremlin Bicetre, France
[11] CHU Nice, Hop Larchet, Lab Bacteriol, F-06202 Nice, France
[12] Univ Paris, Grp Hosp AP HP CUP, Fac Med Paris Ctr, Serv Bacteriol, F-75014 Paris, France
[13] Univ Franche Comte, Ctr Hosp Univ Besancon, Ctr Natl Reference Resistance Antibiot, UMR6249 CNRS Chrono Environm, Besancon, France
[14] Grp Hosp Paris St Joseph, Lab Microbiol & Plateforme Dosage Antiinfectieux, Paris, France
[15] CHRU Tours, Hop Bretonneau, Serv Bacteriol Virol Hyg, F-37000 Tours, France
[16] Univ Reims, CHU Reims, Hosp Parasitol Mycol,Inserm UMR S 1250 P3Cell, Hop Robert Debre,Lab Bacteriol Virol Hyg,SFR CAP, F-51000 Reims, France
[17] Univ Brest, CHRU Brest, INSERM, UMR 1078,Unite Bacteriol, F-29200 Brest, France
[18] CHU Rennes, Serv Bacteriol Hyg Hosp, F-35033 Rennes, France
[19] CHU Dupuytren, Serv Bacteriol Virol Hyg, 2 Ave Martin Luther King, F-87042 Limoges, France
[20] CHU Nantes, Inst Biol, Serv Bacteriol Hyg Hosp, 9 Quai Moncousu, F-44093 Nantes 1, France
[21] CHU Avicenne, Hyg Hosp & Prevent Risque Infectieux, AP HP, 125 Rue Stalingrad, F-93000 Bobigny, France
来源
INFECTIOUS DISEASES NOW | 2022年 / 52卷 / 02期
关键词
INFECTIOUS-DISEASES SOCIETY; BACTERIAL-MENINGITIS; PRACTICE GUIDELINES; PROGNOSTIC-FACTORS; ADULTS; PNEUMONIAE; SPECTRUM; FEATURES; AMERICA; TAIWAN;
D O I
10.1016/j.idnow.2021.05.006
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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/mm(3) [116-5550], 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 preexisting conditions, as well as in case of meningitis following neurosurgical procedures. (c) 2021 Elsevier Masson SAS. Tous droits reserves.
引用
收藏
页码:82 / 86
页数:5
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