Mortality indicators in pneumococcal meningitis: therapeutic implications

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dc.authoridKarakas, Ahmet/0000-0002-0553-8454
dc.authoridElaldi, Nazif/0000-0002-9515-770X
dc.authoridKart Yasar, Kadriye/0000-0003-2963-4894
dc.authoridbalkan, ilker/0000-0002-8977-5931
dc.authoridGozel, Mustafa Gokhan/0000-0001-5187-7388
dc.authoridErsoy, Yasemin/0000-0001-5730-6682
dc.authoridhatipoglu, mustafa/0000-0001-9910-1650
dc.contributor.authorErdem, Hakan
dc.contributor.authorElaldi, Nazif
dc.contributor.authorOztoprak, Nefise
dc.contributor.authorSengoz, Gonul
dc.contributor.authorAk, Oznur
dc.contributor.authorKaya, Selcuk
dc.contributor.authorInan, Asuman
dc.date.accessioned2025-01-27T20:11:52Z
dc.date.available2025-01-27T20:11:52Z
dc.date.issued2014
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractBackground: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.
dc.identifier.doi10.1016/j.ijid.2013.09.012
dc.identifier.endpage19
dc.identifier.issn1201-9712
dc.identifier.issn1878-3511
dc.identifier.pmid24211227
dc.identifier.scopus2-s2.0-84892875049
dc.identifier.scopusqualityQ1
dc.identifier.startpage13
dc.identifier.urihttps://doi.org/10.1016/j.ijid.2013.09.012
dc.identifier.urihttps://hdl.handle.net/20.500.12428/20760
dc.identifier.volume19
dc.identifier.wosWOS:000329981700003
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Sci Ltd
dc.relation.ispartofInternational Journal of Infectious Diseases
dc.relation.publicationcategoryinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20250125
dc.subjectStreptococcus pneumoniae
dc.subjectMeningitis
dc.subjectMortality
dc.subjectPenicillin
dc.subjectResistance
dc.subjectVancomycin
dc.titleMortality indicators in pneumococcal meningitis: therapeutic implications
dc.typeArticle

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