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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

All cases of bacterial meningitis in the neonatal unit at King Edward VIII Hospital, Durban for the period 1 January 1981 to 31 December 1987 were reviewed. In particular, we looked at the impact of cefotaxime on mortality rates and amikacin on the incidence of hospital-acquired Gram-negative bacillary (GNB) meningitis. Klebsiella was found to be the commonest cause of neonatal meningitis, followed by Escherichia coli and Streptococcus agalactiae. Eighty-four per cent of all cases of GNB meningitis presented more than 3 days after birth, with the vast majority being caused by gentamicin-resistant Klebsiella. A decline in the incidence of meningitis from 1.27/1000 live births in 1981 and 0.95/1000 for the period 1981-1986 to 0.22/1000 live births in 1987, with no cases of Klebsiella meningitis being seen in that year, coincided with the exclusive use of amikacin as the parenteral aminoglycoside in place of gentamicin in the unit after August 1986. The initial decline in the incidence of meningitis from 0.93/1000 in 1985 to 0.46/1000 in 1986 was attributed to the introduction in 1985 of strict hand disinfection measures to prevent cross-infection in the unit. The case mortality rate (CMR) fell from 0.65 for the period 1981-1984 to 0.42 for the period 1985-1987, and we believe this was largely a result of the introduction of cefotaxime in 1984 as first-line therapy for GNB meningitis, together with better patient care facilities.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hospital-acquired neonatal bacterial meningitis: the impacts of cefotaxime usage on mortality and of amikacin usage on incidence. 248 5

In an eight year period (1972-1979), 158 cases of enteric gram-negative bacillary meningitis and 53 cases of Listeria meningitis were reported to the New York City Health Department. These two forms of bacterial meningitis were the fourth and fifth most common ones reported to the Department, respectively. The cumulative total of reported cases of gram-negative rod meningitis over this less than the reported cases due to Neisseria meningitis over this period. In contrast to most previous studies of Listeria and enteric gram-negative meningitides, the majority of cases occurred in adults. Listeria meningitis occurred more often in immunosuppressed hosts and the elderly than in the newborn; gram-negative bacillary meningitides were seen more often in elderly septic patients and in patients with traumatic skull fracture than in infants during the first months of life. The over-all mortality of Listeria meningitis was 62 percent; that of the combined gram-negative meningitides 71.3 percent. The mortality in adults with Escherichia coli and Klebsiella meningitis who were treated with chloramphenicol as the major antibiotic was 83 percent. In comparison, the only appreciable survival rates noted were in those with Listeria, Escherichia coli, Proteus mirabilis and Salmonella meningitis who were treated with ampicillin alone in whom the over-all mortality was 51 percent.
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PMID:Listeria and gram-negative bacillary meningitis in New York City, 1972-1979. Frequent causes of meningitis in adults. 702 Apr 16

Klebsiella infection has been considered to be an uncommon cause of meningitis. To determine its incidence and clinical features, we reviewed the microbiologic records of cerebrospinal fluid (CSF) and blood cultures and the medical records of patients with bacterial meningitis admitted between 1981 and 1995. Klebsiella meningitis was diagnosed in 79 patients with 83 episodes. All patients had klebsiella isolated from CSF and/or blood and typical symptoms and signs of acute bacterial meningitis. Of these, 74 were over 16 years of age and 2 of the 5 children were infants. There was an increased prevalence rate of klebsiella meningitis after 1986. Of the 83 episodes, only 9 occurred between 1981 and 1986, accounting for 7.8% of 115 cases with CSF and/or blood culture-proven acute bacterial meningitis, whereas in 1987-95, there were 74 episodes accounting for 17.7% of 419 bacteriologically proven cases. K. pneumoniae accounted for 69 episodes, K. oxytoca, 11 episodes and K. ozaenae, 3 episodes. Male gender, diabetes mellitus and liver cirrhosis were commonly associated with K. pneumoniae meningitis. Neurosurgical procedures were frequently associated with K. oxytoca meningitis. All three patients with K. ozaenae meningitis had a primary disease of the nasopharyngeal pathway. The mortality rate due to K. pneumoniae was 48.5%, K. oxytoca, 10% and K. ozaenae, 0%. In patients with K. pneumoniae meningitis, poor prognostic factors included age over 60 years, diabetes mellitus, bacteremia and severe neurological deficits on the first day of treatment.
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PMID:Klebsiella meningitis in Taiwan: an overview. 936 11

Bacterial meningitis, a world-wide disease, has to be reviewed periodically because the specific micro-organisms responsible for the infection vary with time, geography and patient age. To determine its incidence and clinical features in Taiwan, we reviewed the microbiological records for cerebrospinal fluid (CSF) and blood cultures, and the medical records of patients with bacterial meningitis admitted between 1981 and mid-1998. Bacterial micro-organisms were demonstrated in the CSF and/or blood in 395 patients with 418 episodes of bacterial meningitis. Streptococcus species were the most common causative micro-organism group, at 23. 21% of all episodes. Its prevalence rate significantly decreased from the first 7 years of study (41.9%) to the last 10.5 years (19. 2%). However, Klebsiella meningitis and Staphylococcal meningitis were more frequently noted after 1987. More than 70% of patients had at least one underlying disease or condition. Poor prognostic factors indicated by univariable analysis were: age >60 years; diabetes mellitus; severe neurological deficits on the first day of treatment; infection with Gram-negative bacilli; CSF WBC count >5000x10(6)/l; malignancy; seizure; and bacteraemia. The overall mortality rate was 29.4%, 29.7% in the first 7 years of study and 29. 4% in the last 10.5 years. The use of new antibiotics has not reduced the mortality rate in our patients with bacterial meningitis.
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PMID:Acute bacterial meningitis in adults: a hospital-based epidemiological study. 1058 35

Acute bacterial meningitis is a severe CNS infection occurring mostly in infants and older children. Bacterial meningitis caused by gram-negative bacteria is usually fatal. Klebsiella pneumoniae is an uncommon gram-negative bacteria causing meningitis with a poor outcome. Though the commonest presentation of bacterial meningitis is fever, patients usually seek medical attention for uncontrolled seizure and features of raised ICP. The commonest complications of gram-negative bacterial meningitis including Klebsiella meningitis are subdural hygroma / empyema, hydrocephalus, infarcts (both arterial and venous) and cortical blindness due to hypoxic ischaemic insult. MRI is the best modality for evaluating these patients for early diagnosis. Early institution of treatment significantly reduces the mortality and morbidity. We describe a case of acute bacterial meningitis caused by Klebsiella pneumoniae with MR evidence of sinus thrombosis, venous infarcts and subdural hygroma.
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PMID:Klebsiella meningitis. A case report. 2425