Evidence map›Paper›PMID 38566040›Full record

Observational studyBMC infectious diseases2024

Clinical characteristics and antimicrobial therapy of healthcare-associated carbapenem-non-susceptible gram-negative bacterial meningitis: a 16-year retrospective cohort study.

Jiyan Xu, Xiaoling Du, Dan Li, Pei Li, Qinglan Guo, Xiaogang Xu, Fupin Hu, Minggui Wang

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. The intricacies ofFrontiers in microbiology · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Jiyan XuInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Xiaoling DuInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Dan LiInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Pei LiInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Qinglan GuoInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Xiaogang XuInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Fupin HuInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Minggui WangInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China. mgwang@fudan.edu.cn.
Huashan Hospital · CNFudan University · CN

Funding

National Natural Science Foundation of China 81991531
6 · The paper itself

Abstract

objectiveHealthcare-associated Gram-negative bacterial meningitis is a substantial clinical issue with poor outcomes, especially for neurosurgical patients. Here, we aimed to study the characteristics and treatment options of patients with healthcare-associated carbapenem-non-susceptible (Carba-NS) Gram-negative bacterial meningitis.

methodsThis observational cohort study was conducted at a teaching hospital from 2004 to 2019. The clinical characteristics of patients with meningitis with Carba-NS and carbapenem-susceptible (Carba-S) bacilli were compared, and the antimicrobial chemotherapy regimens and outcomes for Carba-NS Gram-negative bacterial meningitis were analyzed.

resultsA total of 505 patients were included, of whom 83.8% were post-neurosurgical patients. The most common isolates were Acinetobacter spp. and Klebsiella spp., which had meropenem-resistance rates of 50.6% and 42.5%, respectively, and showed a markedly growing carbapenem-resistance trend. Kaplan-Meier curve analysis revealed that Carba-NS Gram-negative bacilli were associated with a significantly higher in-hospital mortality rate (18.8%, 35/186) compared to the Carba-S group (7.4%, 9/122; P = 0.001). For Carba-NS Enterobacterales meningitis, aminoglycoside-based and trimethoprim-sulfamethoxazole-based regimens yielded significantly higher clinical efficacy rates than non-aminoglycoside-based and non-trimethoprim-sulfamethoxazole-based regimens (69.0% vs. 38.7%, P = 0.019 and 81.8% vs. 46.9%, P = 0.036, respectively). For Carba-NS A. baumannii complex meningitis, tetracycline-based (including doxycycline, minocycline, or tigecycline) therapy achieved a significantly higher clinical efficacy rate (62.9%, 22/35) than the non-tetracycline-based therapy group (40.4%, 19/47; P = 0.044).

conclusionsOur findings revealed that Carba-NS Gram-negative bacilli are associated with higher in-hospital mortality in patients with healthcare-associated meningitis. The combination therapies involving particular old antibiotics may improve patients' outcome.

trial registrationThis study was registered on the Chinese Clinical Trial Register under ChiCTR2000036572 (08/2020).

Indexed as

CarbapenemsMeningitis, BacterialAnti-Bacterial AgentsDelivery of Health CareEast Asian PeopleGram-Negative BacteriaHumansMicrobial Sensitivity TestsRetrospective StudiesAnti-Bacterial AgentsCarbapenemsAntimicrobial therapyCarbapenem-resistanceGram-negative bacteriaMeningitisRisk factor

Identifiers

PMID38566040
PMCPMC10985894
OpenAlexW4393397031

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.