Streharova A, Benca J, Holeckova K, Balik J, Sula I, Lesnakova A, Luzinsky L, Pavlikova Z, Adamkovicova E, Spilakova N, Kacunova B, Dovalova V, Kisac P, Beno P, Kalavsky E, Sramka M, Benka J, Ondrusova A, Seckova S, Sladeckova V, Kolenova A, Bartkovjak M, Bukovinova P, Hvizdak F, Lengyel P, Bielova M, Wiczmandyova O, Svabova V, Findova L, Kutna K, Deadline J, Diana E, Krumpolcova M, Kiwou M, Steno J, Stankovic I, Bauer F, Kovac M, Huttova M, Taziarova M, Luzica R, Saniova B, Rudinsky B, Sabo I, Karvaj M, Johnson M J
University Hospital Trnava, Slovakia.
Neuro Endocrinol Lett. 2007 Nov;28 Suppl 3:7-9.
The aim of this study was to assess if differences in etiology and risk factors among 372 cases of bacterial meningitis acquired after surgery (PM) or in community (CBM) have impact on outcome of infected patients. Among 372 cases of bacterial meningitis within last 17 years from 10 major Slovak hospitals, 171 were PM and 201 CBM. Etiology, risk factors such as underlying disease, cancer, diabetes alcoholism, surgery, VLBW, ENT infections, trauma, sepsis were recorded and mortality, survival with sequellae, therapy failure were compared in both groups. Significant differences in etiology and risk factors between both groups were reported. Those after neurosurgery had more frequently Coagulase negative staphylococci (p<0.001), Enterobacteriaceae (p=0.01) and Acinetobacter baumannii (p=0.0008) isolated from CSF and vice versa Streptococcus pneumoniae (p<0.001), Neisseria meningitis (p<0.001) and Haemophillus influenza (p=0.0009) were more commonly isolated from CSF in CBM. Neurosurgery (p<0.001), sepsis (p=0.006), VLBW neonates (p=0.00002) and cancer (p=0.0007) were more common in PM and alcohol abuse (p<0.001) as well as otitis/sinusitis (p<0.001) and Roma ethnic group (p=0.001) in CAM. Initial treatment success was significantly more frequently observed among CAM (p<0.001) but cure after modification was more common in PM (p=0.002). Therefore outcome in both groups was similar (14.6% vs. 12.4%, p=NS).
本研究的目的是评估372例手术后获得性细菌性脑膜炎（PM）或社区获得性细菌性脑膜炎（CBM）的病因和危险因素差异是否会对感染患者的预后产生影响。在斯洛伐克10家主要医院过去17年的372例细菌性脑膜炎病例中，171例为PM，201例为CBM。记录病因、潜在疾病、癌症、糖尿病、酗酒、手术、极低出生体重儿、耳鼻喉感染、创伤、败血症等危险因素，并比较两组的死亡率、有后遗症存活情况和治疗失败情况。报告了两组之间病因和危险因素的显著差异。神经外科手术后患者脑脊液中凝固酶阴性葡萄球菌（p<0.001）、肠杆菌科细菌（p=0.01）和鲍曼不动杆菌（p=0.0008）分离率更高，反之，社区获得性细菌性脑膜炎患者脑脊液中肺炎链球菌（p<0.001）、脑膜炎奈瑟菌（p<0.001）和流感嗜血杆菌（p=0.0009）分离率更常见。神经外科手术（p<0.001）、败血症（p=0.006）、极低出生体重儿（p=0.00002）和癌症（p=0.0007）在手术后获得性细菌性脑膜炎中更常见，而酗酒（p<0.001）、中耳炎/鼻窦炎（p<0.001）和罗姆族（p=0.001）在社区获得性细菌性脑膜炎中更常见。初始治疗成功在社区获得性细菌性脑膜炎中更常见（p<0.001），但调整后治愈在手术后获得性细菌性脑膜炎中更常见（p=0.002）。因此，两组的预后相似（14.6%对12.4%，p=无显著性差异）。
