Observational studyCritical care (London, England)2023
Severe community-acquired Streptococcus pneumoniae bacterial meningitis: clinical and prognostic picture from the intensive care unit.
Observational study in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 14 citations in OpenAlex.
- Severe invasive pneumococcal disease beyond current vaccination recommendations: implications for higher-valency vaccines.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Cerebrospinal fluid procalcitonin and neutrophil percentage: a combined biomarker for differentiating bacterial from tuberculous meningitis in antibiotic-pretreated patients.Frontiers in cellular and infection microbiology · 2026Article
- Global Antimicrobial Non-Susceptibility Patterns ofInfection and drug resistance · 2026Review
- Oxford Nanopore Sequencing in pediatric emergency infectious diseases: from rapid diagnosis to precision medicine.Frontiers in cellular and infection microbiology · 2026Review
- Stem cell-derived brain-like endothelial cells to interrogateVirulence · 2025Article
- Initial management and outcome of community-acquired bacterial meningitis in two French ICUs over a period of fifteen years.BMC infectious diseases · 2025Observational
- Early detection of cerebrospinal fluid/serum glucose ratio: A promising value for mortality prognosis in patients with acute bacterial meningitis.Journal of general and family medicine · 2025Article
- Severe listeriosis in intensive care units: insights from a retrospective multicentric study.Critical care (London, England) · 2025Observational
- Pneumococcal Meningovasculitis: A Deadly Foe.Cureus · 2025Article
- Intracranial complications in adult patients with severe pneumococcal meningitis: a retrospective multicenter cohort study.Annals of intensive care · 2024Article
- Post-Meningitic Syndrome: Pathophysiology and Consequences of Streptococcal Infections on the Central Nervous System.International journal of molecular sciences · 2024Review
- Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects.Antibiotics (Basel, Switzerland) · 2024Review
- Article
- Identifying subgroup of severe community-acquired pneumonia based on clinical metagenomics, a multicenter retrospective cohort study.Frontiers in cellular and infection microbiology · 2024Article
- Protective effect and mechanism of nanoantimicrobial peptide ND-C14 againstWorld journal of emergency medicine · 2024Article
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Authors and funding
11 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevere community-acquired pneumococcal meningitis is a medical emergency. The aim of the present investigation was to evaluate the epidemiology, management and outcomes of this condition.
methodsThis was a retrospective, observational and multicenter cohort study. Sixteen Spanish intensive care units (ICUs) were included. Demographic, clinical and microbiological variables from patients with Streptococcus pneumoniae meningitis admitted to ICU were evaluated. Clinical response was evaluated at 72 h after antibiotic treatment initiation, and meningitis complications, length of stay and 30-day mortality were also recorded.
resultsIn total, 255 patients were included. Cerebrospinal fluid (CSF) culture was positive in 89.7%; 25.7% were non-susceptible to penicillin, and 5.2% were non-susceptible to ceftriaxone or cefotaxime. The most frequent empiric antibiotic regimen was third-generation cephalosporin (47.5%) plus vancomycin (27.8%) or linezolid (12.9%). A steroid treatment regimen was administered to 88.6% of the patients. Clinical response was achieved in 65.8% of patients after 72 h of antibiotic treatment. Multivariate analysis identified two factors associated with early treatment failure: invasive mechanical ventilation (OR 10.74; 95% CI 3.04-37.95, p < 0.001) and septic shock (OR 1.18; 95% CI 1.03-1.36, p = 0.017). The 30-day mortality rate was 13.7%. Only three factors were independently associated with 30-day mortality: delay in start of antibiotic treatment (OR 18.69; 95% CI 2.13-163.97, p = 0.008), Sepsis-related Organ Failure Assessment (SOFA) score (OR 1.36; 95% CI 1.12-1.66, p = 0.002) and early treatment failure (OR 21.75 (3.40-139.18), p = 0.001). Neurological complications appeared in 124 patients (48.63%).
conclusionsMortality rate in critically ill patients with pneumococcal meningitis is lower than previously reported. Delay in antibiotic treatment following admission is the only amendable factor associated with mortality.
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