[Etiology, Prognosis and Risk Factors of 181 Adult Community-acquired Acute Bacterial Meningitis].

OBJECTIVE

To understand the etiology, clinical prognosis and risk factors of adult community-acquired acute bacterial meningitis (ABM) and provide the evidence for clinical diagnosis and treatment.

METHODS

We performed a retrospective study of 181 clinically diagnosed hospitalized patients with community-acquired adult ABM from Jan.2010 to Jan.2018. The patients were categorized as non-elderly (16≤age<65 years old, =156 ) and elderly (age≥65 years old, =25) group. The etiology, clinical features, prognosis and risk factors of the two groups were compared.

RESULTS

Sixty-four of 181 patients (35.4%) had pathogens detected. The most common pathogens were (17.9%), (13.4%) and (10.5%). The mortality of the elderly group was higher than that of the non-elderly group (<0.05). Univariate analysis showed that there was a significant difference between the elderly group and the non-elderly group in the incidence of hypertension, hypokalemia, pulmonary infection, ear-nose-throat ( ENT) infection, cerebrospinal fluid (CSF) protein concentration, head CT abnormalities and mortality. Logistic regression analysis showed that pulmonary infection and temperature ≥38.5 ℃ were independent risk factors for poor prognosis in the non-elderly group. CSF pressure ≥200 mmHO was a independent risk factors for poor prognosis in the elderly group.

CONCLUSION

The pathogens that cause acute bacterial meningitis in adult community are mainly and Pulmonary infection and temperature ≥38.5 ℃ are independent risk factors of poor prognosis in the non-elderly patients, as CSF pressure ≥200 mmHO a independent risk factor in the elderly patients.