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Postoperative meningitis: shift in etiology?

Benca J, Ondrusova A, Kisac P, Krcmery V.
Letter 2007; 28(Suppl 3): 23-24 PubMed PMID: 18030270 Citation  Keywords:  Cross Infection:cerebrospinal fluid, Gram-Negative Bacteria:classification, Humans, Meningitis:cerebrospinal fluid, Neurosurgical Procedures:adverse effects, Postoperative Period, Slovakia:epidemiology, Streptococcal Infections:epidemiology, Surgical Woun.   

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Neuroinfections due to Listeria monocytogenes.

Streharova A, Babjakova A, Moravcikova A, Harnicarova A, Holeckova K, Lesnakova A, Sladeckova V, Seckova S, Kisac P, Beno P.
Journal Article 2007; 28(Suppl 3): 20-21 PubMed PMID: 18030269 Citation  Keywords:  Adult, Aged, Ampicillin:therapeutic use, Anti-Bacterial Agents:therapeutic use, Cefotaxime:therapeutic use, Drug Resistance, Bacterial, Female, Humans, Listeriosis:drug therapy, Male, Meningitis, Bacterial:drug therapy, Middle Aged, Outcome Assessment (He.   

: Listeria monocytogenes is not a rare pathogen causing meningitis, mainly in small children and in close contacts to livestock. The pathogen is naturally resistant to cephalosporins and some glycopeptides as well, therefore despite of syndromologic diagnosis of meningitis and initial therapy with 3rd generation cephalosporins according to the guidelines therapeutic failures with clinical consequences may occur....

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Gram-negative bacillary community acquired meningitis is not a rare entity in last two decades.

Taziarova M, Holeckova K, Lesnakova A, Sladeckova V, Bartkovjak M, Seckova S, Bukovinova P, Hvizdak F, Svabova V, Findova L, Kisac P, Beno P, Bauer F, Bauer M, Karvaj M, Rudinsky B, Sabo I, Bielova M, Luzica R, Wiczmandyova O, Huttova M, Ondrusova A.
Comparative Study 2007; 28(Suppl 3): 18-19 PubMed PMID: 18030268 Citation  Keywords:  Chi-Square Distribution, Community-Acquired Infections:microbiology, Cross Infection:microbiology, Gram-Negative Bacteria:classification, Gram-Negative Bacterial Infections:complications, Humans, Infant, Newborn, Meningitis, Bacterial:complications, Outco.   

: The aim of this short note is to assess gram-negative bacillary community acquired meningitis (CBM) and nosocomial meningitis (NM) within 17 years nationwide survey. All cases of gram-negative bacillary CBM within 1990-2007 were assessed in national database of 372 patients with bacterial meningitis: 69 of gram-negative cases were nosocomial and 24 of gram-negative meningitis cases were CBM. Those 24 cases were compared with all CBM (201 cases) for risk factors and outcome. Among nosocomial gram-negative pathogens, A. baumannii in 23 cases, Ps. aeruginosa in 15 cases and Enterobacteriaceae in 31 cases were isolated. Among CBM, in 13 cases Enterobacteriaceae (Escherichia coli 6, Klebsiella pneumoniae 3, Proteus mirabilis 2, Enterobacter cloacae 2), in 5 cases Ps. aeruginosa and in 6 cases Acinetobacter baumannii were isolated from cerebrospinal fluid (CSF). The only significant risk factor for CBM due to gram-negative bacilli was neonatal age (12.5% vs. 3.5%, p=0.04) as underlying disease. However, mortality among gram-negative bacillary meningitis was significantly higher (12.4% vs. 37.5%, p=0.001) in comparison to other meningitis....

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Pneumococcal meningitis in community is frequent after craniocerebral trauma and in alcohol abusers.

Benca J, Lesnakova A, Holeckova K, Ondrusova A, Wiczmandyova O, Sladecko V, Hvizdak F, Bartkovjak M, Seckova S, Taziarova M, Huttova M, Bielova M, Luzica R, Karvaj M, Kovac M, Bauer F, Sabo I, Svabova V, Findova L, Bukovinova P, Shahum A.
Comparative Study 2007; 28(Suppl 3): 16-17 PubMed PMID: 18030267 Citation  Keywords:  Alcohol-Related Disorders:complications, Anti-Bacterial Agents:therapeutic use, Community-Acquired Infections:complications, Craniocerebral Trauma:complications, Humans, Macrolides:therapeutic use, Meningitis:complications, Meningitis, Pneumococcal:compli.   

: Aim of this short communication was to assess risk factors and outcome of community acquired pneumococcal meningitis and compare it to all cases of community acquired meningitis. Univariate analysis was used for comparison of 68 pneumococcal to 201 CBM within a Slovak nationwide database of CBM. Significant risk factors for pneumococcal meningitis were previous craniocerebral trauma within 7 days (39.7% vs. 14.9%, p=0.00002), splenectomy (10.3% vs. 3.5%, p=0.03) and alcohol abuse (36.8% vs. 15.4%, p=0.0001). Concerning outcome, mortality was similar (8,8% and 12,4%, NS), proportion of those with neurologic sequellae after CBM due to Str. pneumoniae was insignificantly higher (20.6% vs. 15.4%, NS) in comparison to all CBM. All but 2 strains Str. pneumoniae were susceptible to penicillin and macrolides (3.3% resistance)....

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Bacterial meningitis after sinusitis and otitis media: ear, nose, throat infections are still the commonest risk factors for the community acquired meningitis.

Lesnakova A, Holeckova K, Kolenova A, Streharova A, Kisac P, Beno P, Kalavsky E, Sramka M, Ondrusova A, Benca J, Seckova S, Sladeckova V, Bartkovjak M, Bukovinova P, Hvizdak F, Lengyel P, Sabo I, Rudinsky B, Bauer F, Luzica R, Bielova M, Karvaj M, Huttova M, Wiczmandyova O, Svabova V, Findova L, Kutna K, Deadline J, Diana E, Kiwou M.
Journal Article 2007; 28(Suppl 3): 14-15 PubMed PMID: 18030266 Citation  Keywords:  Alcohol-Related Disorders:complications, Anti-Bacterial Agents:therapeutic use, Community-Acquired Infections:etiology, Diabetes Complications, Humans, Meningitis, Bacterial:etiology, Otitis Media:complications, Outcome Assessment (Health Care), Risk Fact.   

: We investigated how many cases of bacterial meningitis in our national survey were associated with sinusitis or otitis media. Among 372 cases of bacterial meningitis within our nationwide 17 years survey, 201 cases were community acquired (CBM) and in 40 (20%) otitis media or sinusitis acuta/chronica were reported 1-5 weeks before onset of CBM. Diabetes mellitus (20% vs. 7.5%, p=0.01), alcohol abuse (35% vs. 15.4%, p=0.003) and trauma (30% vs. 14.9%, p=0.02) were significantly associated with CBM after ENT infections. Concerning etiology, CBM after sinusitis/otitis was insignificantly associated with pneumococcal etiology (50% vs. 33.8 %, NS) and significantly associated with other (L. monocytogenes, Str. agalactiae) bacterial agents (9.9 % vs. 25 %, p=0.008) . However those significant differences for new ENT related CBM had no impact on mortality (12.4 % vs. 5%, NS), failure after initial antibiotics (10 % vs. 9.5%, NS) and neurologic sequellae (12.5 % vs. 15.4 %, NS)....

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Bacterial meningitis after craniocerebral trauma in the community.

Holeckova K, Kolenova A, Lesnakova A, Steno J, Streharova A, Kisac P, Beno P, Kalavsky M, Sramka M, Ondrusova A, Benca J, Seckova S, Sladeckova V, Bartkovjak M, Bukovinova P, Hvizdak F, Lengyel P, Svabova V, Findova L, Kutna K, Deadline J, Johnson M, Namulanda V, Juma O, Okoth V, Kovac M, Rudinsky B, Bauer F, Karvaj M, Sabo I, Huttova M, Kenderessy P, Nosko J, Paulikova T, Rusnak R, Povinsky J, Galla S.
Journal Article 2007; 28(Suppl 3): 12-13 PubMed PMID: 18030265 Citation  Keywords:  Alcohol-Related Disorders:complications, Anti-Bacterial Agents:therapeutic use, Bacteria:classification, Brain Damage, Chronic:etiology, Cohort Studies, Community-Acquired Infections:etiology, Craniocerebral Trauma:complications, Humans, Meningitis, Bacte.   

: Craniocerebral trauma is one of major risk factors for development of meningitis. We reviewed 30 cases of bacterial meningitis occurring in community after craniocerebral trauma. Alcohol abuse was significant risk factor occurring in trauma patients with meningitis present in 50% in our cohort (p=0.0001). The most common pathogen in posttraumatic meningitis was Str. pneumoniae (90% vs. 33.8%, p=0.0001). However mortality was very low, only 5% probably because of early diagnosis and treatment of patients at risk for bacterial meningitis but neurologic sequellea were significantly more common (p=0.00001) in patients after craniocerebral trauma....

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Meningitis in tropics--what is the optimal initial therapy?

Benca J, Duong L, Shahum A, Ondrus A, Koleno A, Bartkovjak M, Sladecko V, Muli J.
Comparative Study 2007; 28(Suppl 3): 10-11 PubMed PMID: 18030264 Citation  Keywords:  Africa South of the Sahara, Aged, Aged, 80 and over, Anti-Infective Agents:classification, Child, Child, Preschool, Community-Acquired Infections:therapy, European Union, Humans, Infant, Newborn, Meningitis, Bacterial:therapy, North America, South America.   

: Risk factors, etiology, epidemiology and initial therapy of community acquired meningitis in tropics is briefly reviewed....

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Comparison of postsurgical and community acquired bacterial meningitis--analysis of 372 cases within a nationwide survey.

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.
Comparative Study 2007; 28(Suppl 3): 7-9 PubMed PMID: 18030263 Citation  Keywords:  Community-Acquired Infections:complications, Cross Infection:complications, Humans, Meningitis, Bacterial:etiology, Neurosurgical Procedures:adverse effects, Postoperative Complications:microbiology, Risk Factors, Slovakia:epidemiology, Statistics, Nonpar.   

: 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)....

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