Pedersen Michael, Benfield Thomas L, Skinhoej Peter, Jensen Allan G
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
BMC Infect Dis. 2006 Mar 16;6:49. doi: 10.1186/1471-2334-6-49.
Haematogenous Staphylococcus aureus meningitis is rare but associated with high mortality. Knowledge about the disease is still limited. The objective of this study was to evaluate demographic and clinical prognostic features of bacteraemic S. aureus meningitis.
Nationwide surveillance in Denmark from 1991 to 2000 with clinical and bacteriological data. Risks of death were estimated by Cox proportional hazards regression analysis.
Among 12480 cases of S. aureus bacteraemia/sepsis, we identified 96 cases of non-surgical bacteraemic S. aureus meningitis (0.8%). Incidence rates were 0.24 (95% confidence interval [CI], 0.18 to 0.30)/100,000 population between 1991-1995 and 0.13 (CI, 0.08 to 0.17)/100,000 population between 1996-2000. Mortality was 56%. After adjustment, only co morbidity (hazard ratio [HR], 3.45; CI, 1.15 to 10.30) and critical illness (Pitt score > or = 4) (HR, 2.14; CI, 1.09 to 4.19) remained independent predictors of mortality.
The incidence, but not mortality of bacteraemic S. aureus meningitis decreased during the study period. Co morbidity and critical illness were independent predictors of a poor outcome.
血源性金黄色葡萄球菌脑膜炎较为罕见，但死亡率很高。对该疾病的了解仍然有限。本研究的目的是评估血行性金黄色葡萄球菌脑膜炎的人口统计学和临床预后特征。
1991年至2000年在丹麦进行全国性监测，收集临床和细菌学数据。通过Cox比例风险回归分析估计死亡风险。
在12480例金黄色葡萄球菌菌血症/败血症病例中，我们确定了96例非手术性血行性金黄色葡萄球菌脑膜炎病例（0.8%）。1991 - 1995年间发病率为0.24（95%置信区间[CI]，0.18至0.30）/10万人口，1996 - 2000年间为0.13（CI，0.08至0.17）/10万人口。死亡率为56%。调整后，只有合并症（风险比[HR]，3.45；CI，1.15至10.30）和危重病（皮特评分≥4）（HR，2.14；CI，1.09至4.19）仍然是死亡率的独立预测因素。
在研究期间，血行性金黄色葡萄球菌脑膜炎的发病率下降，但死亡率未下降。合并症和危重病是预后不良的独立预测因素。
