Epidemiology of bacterial meningitis during a 5-year period in an infectious diseases unit in northern Italy
Abstract number: P717
Azzini A.M., Grigolo C., Tedesco A., Concia E.
Objective: To evaluate the frequency of isolation of S. pneumoniae (SP), N. meningitidis (NM), H. influenzae (HI), L. monocytogenes (LM) and other bacteria during meningitis, also defining their patterns of antibiotic susceptibilities, in order to optimise both prevention strategies and antibiotic therapy of this severe infection.
Methods: During a 5 years period (January 2002June 2007) we prospectively evaluated patients affected by meningitis, in particular we collected their demographic data, the presence of co-morbidities and meningeal infection's predisposing factors. Liquor biochemical characteristic together with microbiological results were reported; the susceptibility test were performed by Kirby Bauer method.
Results: During the study period we collected 31 bacterial meningitis (BM), increasing from 2002 (4 cases) to 2006 (10 cases), with this trend confirmed during the first half of 2007 (6 cases). During the first three years period we found only SP as causal agent, but from 2005 NM has appeared and become predominant in relationship with other bacteria. During the study period we had only two LM (in 2002 and 2006) and one HI (2006). SP has never found to be penicillin resistant but in 25% of cases it showed an intermediate susceptibility to this antibiotic. 80% of NM was resistant-intermediate to penicillin. The only isolated HI didn't produce b-lactamases.
Conclusions: In our Institution BM is becoming more frequent than in the past, and this disagree with national data which show a trend in reduction from 2006. In particular we noted an increasing NM's frequency of isolation, with a predominance in last 3 years if compared with SP, which remained quite constant. This data are too limited to be interpreted as an outbreak but they call our attention to preventive interventions such as vaccination for this severe infection.
In contrast with European Antimicrobial Resistance Surveillance System data, the frequency of isolation of penicillin-resistant SP is low, but we frequently found penicillin resistant-intermediate NM. These antibiotic patterns support our empirical antibiotic approach to BM with ceftriaxone (2 gr bid i.v.) in association with levofloxacin (500 mg bid i.v.) which shows in vitro activity against LM as well. The effectiveness of this antibiotic treatment is proved by the mortality for BM as well, that was 0% during the study period.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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