Clinical Insights and Outcomes in Community-Acquired Acute Bacterial Meningitis versus Postoperative Bacterial Meningitis

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KARAKOÇ PARLAYAN H. N., Solay A. H., Aksoy B. R., Bulut D., Hojabri M., Sencan I.

Journal of the College of Physicians and Surgeons Pakistan, cilt.34, sa.12, ss.1441-1447, 2024 (SCI-Expanded, Scopus)

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Objective: To compare the demographics, clinical characteristics, and in-hospital mortality rates between community-acquired bacterial meningitis cases and postoperative bacterial meningitis. Study Design: Analytical study. Place and Duration of the Study: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from 2016 to 2022. Methodology: A total of 153 patients diagnosed with bacterial meningitis were included and categorised into two groups: 95 (62.1%) with community-acquired bacterial meningitis (CABM) and 58 (37.9%) with postoperative bacterial meningitis (POBM). Demographics, clinical features, laboratory, paraclinical findings, treatments, and outcomes of the cases were compared. Data were retrieved using a standard data collection form from the electronic medical records. Results: A substantial portion (58.8%) of all patients had comorbidities. Fever was the common symptom in all groups. Headache, neck stiffness, nausea, and vomiting were more often observed in the CABM group (p <0.001). Upon admission, the CABM exhibited higher levels of white blood cell count, C-reactive protein, and procalcitonin (p = 0.017, p = 0.004, p = 0.007, respectively). Overall 33.1% had positive cerebrospinal fluid cultures. The overall mortality rate was 26.8%. POBM was associated with longer hospital and intensive care unit (ICU) stays (p <0.001). Shorter treatment durations, lower Glasgow coma scale scores (GCS), higher Charlson Comorbidity Index values, and elevated markers of inflammation were related to mortality. Conclusion: This study illuminates the differences in clinical presentations and outcomes between community-acquired and postoperative bacterial meningitis. It also suggests that factors such as lower GCS scores, comorbidities, and elevated inflammation markers at the last follow-up may be associated with unfavourable clinical outcomes in bacterial meningitis.