Department of Neurology, Neuroscience, University of Amsterdam, Meibergdreef, Amsterdam UMC, Amsterdam, the Netherlands.
Department of Neurology, Neuroscience, University of Amsterdam, Meibergdreef, Amsterdam UMC, Amsterdam, the Netherlands.
J Infect. 2021 May;82(5):145-150. doi: 10.1016/j.jinf.2021.03.016. Epub 2021 Mar 25.
Haemophilus influenzae is an uncommon cause of meningitis in adults.
We analyzed episodes of community-acquired H. influenzae meningitis in adults included in a prospective nationwide cohort study in the Netherlands.
From 2006 to July 2018, 82 of 2272 (4%) bacterial meningitis episodes were caused by H. influenzae (mean annual incidence 0.5 patients per 1,000,000). Median age was 61 years (IQR 46-68), and 48 episodes (59%) occurred in woman. Predisposing factors were otitis and/or sinusitis in 33 of 76 patients (49%), immunocompromising conditions in 19 of 75 patients (25%) and cerebrospinal fluid leak in 13 of 79 patients (17%). Serotyping showed 63 of 80 isolates (79%) were non-typeable (NTHi). Three patients (4%) died and 14 patients (17%) had an unfavorable outcome (Glasgow Outcome Scale score < 5 at discharge). Pneumonia (odds ratio [OR] 5.8, 95% confidence interval [95%CI] 1.1-30.8), presence of immunocompromising conditions (OR 6.0, 95%CI 1.5-24.4), and seizures on admission (OR 10.7, 95%CI 1.6-72.8) were associated with an unfavorable outcome, while NTHi was associated with a favorable outcome (OR 5.6, 95%CI 1.6-19.5).
H. influenzae is an uncommon cause of adult bacterial meningitis patients mainly causing disease in those with predisposing factors, such as CSF leakage, ENT infections, and immunocompromised state. In adult patients the majority of H. influenzae meningitis is caused by non-typeable strains.
流感嗜血杆菌是成人细菌性脑膜炎的罕见病因。
我们分析了纳入荷兰一项全国性前瞻性队列研究的社区获得性流感嗜血杆菌脑膜炎成人病例。
2006 年至 2018 年 7 月，2272 例细菌性脑膜炎病例中 82 例（4%）由流感嗜血杆菌引起（年发病率为每 100 万人中有 0.5 例患者）。中位年龄为 61 岁（四分位距 46-68），48 例（59%）发生于女性。76 例患者中有 33 例（49%）存在中耳炎和/或鼻窦炎、75 例患者中有 19 例（25%）存在免疫功能低下的情况、79 例患者中有 13 例（17%）存在脑脊液漏。血清分型显示 80 株分离株中有 63 株（79%）为不可分型（NTHi）。3 例（4%）患者死亡，14 例（17%）患者预后不良（出院时格拉斯哥预后评分<5）。肺炎（比值比 [OR] 5.8，95%置信区间 [95%CI] 1.1-30.8）、存在免疫功能低下的情况（OR 6.0，95%CI 1.5-24.4）和入院时出现癫痫发作（OR 10.7，95%CI 1.6-72.8）与预后不良相关，而 NTHi 与预后良好相关（OR 5.6，95%CI 1.6-19.5）。
流感嗜血杆菌是成人细菌性脑膜炎的罕见病因，主要发生于存在 CSF 漏、耳鼻喉感染和免疫功能低下等易患因素的患者。在成人患者中，大多数流感嗜血杆菌脑膜炎是由不可分型菌株引起的。
