Characteristics and outcome of spontaneous bacterial meningitis in patients with diabetes mellitus
Open Access
- 20 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 20 (1), 1-9
- https://doi.org/10.1186/s12879-020-05023-5
Abstract
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.This publication has 49 references indexed in Scilit:
- Spontaneous gram-negative bacillary meningitis in adult patients: characteristics and outcomeBMC Infectious Diseases, 2013
- The spectrum of acute bacterial meningitis in elderly patientsBMC Infectious Diseases, 2013
- Bacterial Meningitis in the United States, 1998–2007The New England Journal of Medicine, 2011
- Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial MeningitisClinical Microbiology Reviews, 2010
- Nosocomial Bacterial MeningitisThe New England Journal of Medicine, 2010
- Hyperglycemia in bacterial meningitis: a prospective cohort studyBMC Infectious Diseases, 2009
- Immunohaematological reference values in human immunodeficiency virus-negative adolescent and adults in rural northern TanzaniaBMC Infectious Diseases, 2009
- Community-Acquired Listeria monocytogenes Meningitis in AdultsClinical Infectious Diseases, 2006
- New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortalityJournal of Clinical Epidemiology, 2004
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987