Characteristics and outcome of spontaneous bacterial meningitis in patients with diabetes mellitus
Por:
Pomar, V, de Benito, N, Mauri, A, Coll, P, Gurgui, M, Domingo, P
Publicada:
20 abr 2020
Resumen:
Background Studies on bacterial meningitis in diabetics patients versus non-diabetics are scarce. In patients with diabetes, bacterial meningitis may have a different presentation, etiology and course. We analyzed and compared the characteristics and outcome of spontaneous BM in adult patients with and without diabetes mellitus (DM). Methods We performed a single-center, prospective observational cohort study, conducted between 1982 and 2017, in a tertiary university hospital in Barcelona (Spain). The primary outcome measure was in-hospital mortality. Results We evaluated 715 episodes of bacterial meningitis; 106 patients (15%) had diabetes mellitus. Patients with diabetes were older (median 67 [IQR 17] vs 49 [IQR 40] years, p < 0.001) and more often had a Charlson comorbidity score of >= 3 (40% vs 15%, p < 0.001). Neck stiffness (56% vs 75%, p < 0.001), headache (41% vs 78%) p < 0.001), nausea and/or vomiting (32% vs 56% p < 0.001), and rash (12% vs 26%, p = 0.007) were less frequent in diabetics, whereas altered mental status was more common. Streptococcus pneumoniae and Listeria meningitis were the most common etiologic agents (24 and 18%, respectively). Listeria was more frequent (18% vs. 10%, p = 0.033), whereas meningococcal meningitis was less frequent (10% vs 32%, p < 0.001). Overall mortality was higher in patients with diabetes (26% vs 16%, p = 0.025) concerning non-diabetics. Conclusions Patients with bacterial meningitis and diabetes mellitus are older, have more comorbidities, and higher mortality. S. pneumoniae and L. monocytogenes are the predominant pathogens, Listeria being more common, whereas Neisseria meningitidis is significantly less frequent than in non-diabetics.
Filiaciones:
Pomar, V:
Univ Autonoma Barcelona, Dept Internal Med, Hosp Santa Creu & St Pau, Infect Dis Unit,Inst Invest Biomed St Pau, Barcelona, Spain
de Benito, N:
Univ Autonoma Barcelona, Dept Internal Med, Hosp Santa Creu & St Pau, Infect Dis Unit,Inst Invest Biomed St Pau, Barcelona, Spain
Mauri, A:
Hosp Santa Creu & Sant Pau, Emergency Dept, Barcelona, Spain
Coll, P:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Inst Invest Biomed St Pau, Dept Clin Microbiol, Barcelona, Spain
Gurgui, M:
Univ Autonoma Barcelona, Dept Internal Med, Hosp Santa Creu & St Pau, Infect Dis Unit,Inst Invest Biomed St Pau, Barcelona, Spain
Domingo, P:
Univ Autonoma Barcelona, Dept Internal Med, Hosp Santa Creu & St Pau, Infect Dis Unit,Inst Invest Biomed St Pau, Barcelona, Spain
Gold, Green Published
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