Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/479
Título : Three-year multicenter surveillance of community-acquired Listeria monocytogenes meningitis in adults
Autor : Amaya-Villar, Rosario
García-Cabrera, Emilio
Sulleiro-Igual, Elena
Fernández-Viladrich, Pedro
Fontanals-Aymerich, Dionisi
Catalán-Alonso, Pilar
Rodrigo-Gonzalo de Liria, Carlos
Coloma-Conde, Ana
Grill-Díaz, Fabio
Guerrero-Espejo, Antonio
Pachón, Jerónimo
Prats-Pastor, Guillén
Filiación: [Amaya-Villar,R] Intensive Care Unit. Hospital Universitario Virgen del Rocío. Av Manuel Siurot s/n, 41013 Sevilla, Spain. [García-Cabrera,E;Pachón,J] Spanish Network for Research in Infectious Disease (REIPI). Hospital Universitario Virgen del Rocío. Sevilla, Spain. Instituto de Biomedicina de Sevilla (IBIS) Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain. [Sulleiro-Igual,E; Prats-Pastor,G] Clinical Microbiology Department. Hospital Universitari Vall d'Hebron, Barcelona, Spain. [Fernández-Viladrich,P] Infectious Disease Service. Hospial Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. [Fontanals-Aymerich,D] Clinical Microbiology Department. Corporació Sanitària Parc Tauli, Sabadell, Spain.[Catalán-Alonso,P] Department of Clinical Microbiology and Infectious Diseases. Hospital Universitario Gregorio Marañón, Madrid, Spain.[Rodrigo-Gonzalo de Liria,C] Pediatrics Department. Infectious Disease Unit. Hospital Germans Trias i Pujol, Badalona, Spain. [Coloma-Conde,A] Infectious Disease Service. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.[Grill-Díaz,F] Intensive Care Unit Infectious Disease Service. Hospital Ramón y Cajal, Madrid, Spain. [Guerrero-Espejo,A] Internal Medicine Departament. Hospital de la Ribera, Alzira, Valencia, Spain. [Pachón,J] Infectious Disease, Microbiology and Preventive medicine Clinical Unit. Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Palabras clave : Meningitis por Listeria
Listeria monocytogenes
Infecciones Comunitarias Adquiridas
Estudios Prospectivos
Análisis Multivariante
Anciano de 80 o más Años
España
MeSH: Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged::Aged, 80 and over
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Community-Acquired Infections
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Bacillales::Listeria::Listeria monocytogenes
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Central Nervous System Bacterial Infections::Meningitis, Bacterial::Meningitis, Listeria
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Fecha de publicación : 11-Nov-2010
Editorial : BioMed Central
Cita Bibliográfica: Amaya-Villar R, García-Cabrera E, Sulleiro-Igual E, Fernández-Viladrich P, Fontanals-Aymerich D, Catalán-Alonso P, et al. Three-year multicenter surveillance of community-acquired Listeria monocytogenes meningitis in adults. BMC Infect. Dis.; 10:324
Abstract: BACKGROUND. Listeria monocytogenes is the third most frequent cause of bacterial meningitis. The aim of this study is to know the incidence and risk factors associated with development of acute community-acquired Lm meningitis in adult patients and to evaluate the clinical features, management, and outcome in this prospective case series. METHODS. A descriptive, prospective, and multicentric study carried out in 9 hospitals in the Spanish Network for Research in Infectious Diseases (REIPI) over a 39-month period. All adults patients admitted to the participating hospitals with the diagnosis of acute community-acquired bacterial meningitis (Ac-ABM) were included in this study. All these cases were diagnosed on the basis of a compatible clinical picture and a positive cerebrospinal fluid (CSF) culture or blood culture. The patients were followed up until death or discharge from hospital. RESULTS. Two hundred and seventy-eight patients with Ac-ABM were included. Forty-six episodes of Lm meningitis were identified in 46 adult patients. In the multivariate analysis only age (OR 1.026; 95% CI 1.00-1.05; p = 0.042), immunosuppression (OR 2.520; 95% CI 1.05-6.00; p = 0.037), and CSF/blood glucose ratio (OR 39.42; 95% CI 4.01-387.50; p = 0.002) were independently associated with a Lm meningitis. The classic triad of fever, neck stiffness and altered mental status was present in 21 (49%) patients, 32% had focal neurological findings at presentation, 12% presented cerebellum dysfunction, and 9% had seizures. Twenty-nine (68%) patients were immunocompromised. Empirical antimicrobial therapy was intravenous ampicillin for 34 (79%) of 43 patients, in 11 (32%) of them associated to aminoglycosides. Definitive ampicillin plus gentamicin therapy was significantly associated with unfavourable outcome (67% vs 28%; p = 0.024) and a higher mortality (67% vs 32%; p = 0.040).The mortality rate was 28% (12 of 43 patients) and 5 of 31 (16.1%) surviving patients developed adverse clinical outcome. CONCLUSIONS Elderly or immunocompromised patients, and a higher CSF/blood glucose ratio in patients with Ac-ABM must alert clinicians about Lm aetiology. Furthermore, we observed a high incidence of acute community-acquired Lm meningitis in adults and the addition of aminoglycosides to treatment should be avoid in order to improve the patients' outcome. Nevertheless, despite developments in intensive care and antimicrobial therapy, this entity is still a serious disease that carries high morbidity and mortality rates.
Descripción : Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/479
Versión del editor : http://www.biomedcentral.com/1471-2334/10/324
DOI: 10.1186/1471-2334-10-324
ISSN : 1471-2334
Appears in Collections:01- Artículos - IBIS. Instituto de Biomedicina de Sevilla
01- Artículos - Hospital Virgen del Rocío

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