9bb72e8c0d57b480025e4a8549680d78 pmc_10253325.pdf 6411d89f7f1e1f324de24d01fa0f84eb5e20d00f pmc_10253325.pdf c82ff87dda4adcef6645247288cb3db8f43d311d13a97f16161f5121faca0497 pmc_10253325.pdf Title: Acute Bacterial Meningitis in Healthy Adult Patients: A Prospective Cohort Study Subject: Spontaneous bacterial meningitis (BM) is more common among patients with underlying conditions, but its characteristics in previously healthy patients are not well described. We analyzed the time trends of BM in terms of characteristics, and outcomes in patients without comorbidities. Patients and methods: Single-center, prospective observational cohort study of 328 adults with BM hospitalized in a tertiary university hospital in Barcelona (Spain). We compared the features of infections diagnosed in 1982–2000 and 2001–2019. The main outcome measure was in-hospital mortality. Results: The median age of the patients increased from 37 to 45 years. Meningococcal meningitis significantly diminished (56% versus 31%, p < 0.000) whereas listerial meningitis increased (1.2% versus 8%, p = 0.004). Systemic complications were more common in the second period, although mortality did not vary significantly between periods (10.4% versus 9.2%). However, after adjusting for relevant variables, infection in the second period was associated with lower risk death. Conclusions: Adult patients without underlying comorbidities that developed BM in recent years were older and more likely to have pneumococcal or listerial infections and systemic complications. In-hospital death was less likely in the second period, after adjusting for risk factors of mortality. Keywords: spontaneous meningitis; bacterial meningitis; cerebrospinal fluid analysis; healthy patient Author: Virginia Pomar, Natividad Benito, Pol Duch, Marc Colomé, Alba Rivera and Pere Domingo Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue May 23 13:01:07 2023 CEST ModDate: Tue May 23 13:03:26 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 8 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 291702 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- AWHDWW+VnURWPalladioL Type 1 Custom yes yes no 10 0 ICRMMT+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 BSDQCY+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 ZMRSKN+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 BTFGED+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 ALRLBO+CMSY10 Type 1 Builtin yes yes no 71 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 75 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 82 0 RIJDHR+CMBSY10 Type 1 Builtin yes yes no 92 0 SYVAVM+VnURWPalladioL-Italic Type 1 Custom yes yes no 105 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-04-26 02:41:34 CEST RepresentationInformation: pmc_10253325.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-04-24 02:40:50 CEST Size: 291702 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 229 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Setting and Study Population Destination: subsection.2.1 Item: Title: Microbiology Methods Destination: subsection.2.2 Item: Title: Statistical Analysis Destination: subsection.2.3 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Acute Bacterial Meningitis in Healthy Adult Patients: A Prospective Cohort Study Author: Virginia Pomar, Natividad Benito, Pol Duch, Marc Colomé, Alba Rivera and Pere Domingo Subject: Spontaneous bacterial meningitis (BM) is more common among patients with underlying conditions, but its characteristics in previously healthy patients are not well described. We analyzed the time trends of BM in terms of characteristics, and outcomes in patients without comorbidities. Patients and methods: Single-center, prospective observational cohort study of 328 adults with BM hospitalized in a tertiary university hospital in Barcelona (Spain). We compared the features of infections diagnosed in 1982 2000 and 2001 2019. The main outcome measure was in-hospital mortality. Results: The median age of the patients increased from 37 to 45 years. Meningococcal meningitis significantly diminished (56% versus 31%, p < 0.000) whereas listerial meningitis increased (1.2% versus 8%, p = 0.004). Systemic complications were more common in the second period, although mortality did not vary significantly between periods (10.4% versus 9.2%). However, after adjusting for relevant variables, infection in the second period was associated with lower risk death. Conclusions: Adult patients without underlying comorbidities that developed BM in recent years were older and more likely to have pneumococcal or listerial infections and systemic complications. In-hospital death was less likely in the second period, after adjusting for risk factors of mortality. Keywords: spontaneous meningitis; bacterial meningitis; cerebrospinal fluid analysis; healthy patient Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue May 23 13:01:07 CEST 2023 ModDate: Tue May 23 13:03:26 CEST 2023 ID: 0xd0c44995d78d8f002252548568bc368e, 0xd0c44995d78d8f002252548568bc368e Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: QLBIEB+URWPalladioL-BoldItal FontSubset: true FirstChar: 110 LastChar: 112 FontDescriptor: FontName: QLBIEB+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: BSDQCY+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 233 FontDescriptor: FontName: BSDQCY+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: ALRLBO+CMSY10 FontSubset: true FirstChar: 15 LastChar: 21 FontDescriptor: FontName: ALRLBO+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: ZMRSKN+URWPalladioL-Ital FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: ZMRSKN+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: SYVAVM+VnURWPalladioL-Italic FontSubset: true FirstChar: 226 LastChar: 226 FontDescriptor: FontName: SYVAVM+VnURWPalladioL-Italic Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: AWHDWW+VnURWPalladioL FontSubset: true FirstChar: 161 LastChar: 243 FontDescriptor: FontName: AWHDWW+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: OVNEXW+EURM10 FontSubset: true FirstChar: 22 LastChar: 22 FontDescriptor: FontName: OVNEXW+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true Font: BaseFont: BTFGED+VnURWPalladioL-Bold FontSubset: true FirstChar: 178 LastChar: 178 FontDescriptor: FontName: BTFGED+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: RIJDHR+CMBSY10 FontSubset: true FirstChar: 21 LastChar: 21 FontDescriptor: FontName: RIJDHR+CMBSY10 Flags: Symbolic FontBBox: -26, -940, 1332, 825 FontFile: true Font: BaseFont: ICRMMT+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 150 FontDescriptor: FontName: ICRMMT+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 99, 281, 152, 290 Annotation: Subtype: Link Rect: 34, 269, 102, 278 Annotation: Subtype: Link Rect: 34, 164, 96, 186 Annotation: Subtype: Link Rect: 126, 90, 154, 99 Annotation: Subtype: Link Rect: 34, 78, 147, 87 Annotation: Subtype: Link Rect: 34, 756, 176, 792 Annotation: Subtype: Link Rect: 515, 756, 560, 792 Annotation: Subtype: Link Rect: 117, 660, 128, 674 Annotation: Subtype: Link Rect: 229, 660, 240, 674 Annotation: Subtype: Link Rect: 293, 660, 304, 674 Annotation: Subtype: Link Rect: 542, 660, 553, 674 Annotation: Subtype: Link Rect: 348, 232, 355, 241 ActionDest: 99 Annotation: Subtype: Link Rect: 358, 232, 365, 241 ActionDest: 99 Annotation: Subtype: Link Rect: 411, 207, 418, 216 ActionDest: 99 Annotation: Subtype: Link Rect: 421, 207, 433, 216 ActionDest: 99 Annotation: Subtype: Link Rect: 300, 182, 307, 191 ActionDest: 99 Annotation: Subtype: Link Rect: 307, 182, 319, 191 ActionDest: 99 Annotation: Subtype: Link Rect: 320, 182, 332, 191 ActionDest: 99 Annotation: Subtype: Link Rect: 274, 119, 286, 128 ActionDest: 99 Annotation: Subtype: Link Rect: 286, 119, 298, 128 ActionDest: 99 Annotation: Subtype: Link Rect: 299, 119, 311, 128 ActionDest: 99 Annotation: Subtype: Link Rect: 130, 17, 267, 28 Annotation: Subtype: Link Rect: 424, 17, 560, 28 Annotation: Subtype: Link Rect: 34, 354, 87, 373 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 411, 656, 418, 665 ActionDest: 99 Annotation: Subtype: Link Rect: 418, 656, 430, 665 ActionDest: 99 Annotation: Subtype: Link Rect: 431, 656, 443, 665 ActionDest: 99 Annotation: Subtype: Link Rect: 443, 656, 455, 665 ActionDest: 99 Annotation: Subtype: Link Rect: 465, 568, 472, 577 ActionDest: 99 Annotation: Subtype: Link Rect: 473, 568, 485, 577 ActionDest: 99 Annotation: Subtype: Link Rect: 485, 568, 497, 577 ActionDest: 99 Annotation: Subtype: Link Rect: 498, 568, 510, 577 ActionDest: 99 Annotation: Subtype: Link Rect: 314, 430, 326, 439 ActionDest: 99 Annotation: Subtype: Link Rect: 449, 63, 456, 75 ActionDest: 79 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 525, 190, 532, 200 ActionDest: 79 Annotation: Subtype: Link Rect: 552, 190, 559, 200 ActionDest: 86 Annotation: Subtype: Link Rect: 358, 163, 365, 175 ActionDest: 86 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 312, 394, 318, 406 ActionDest: 86 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 393, 657, 400, 669 ActionDest: 89 Annotation: Subtype: Link Rect: 381, 352, 388, 361 ActionDest: 99 Annotation: Subtype: Link Rect: 391, 352, 403, 361 ActionDest: 99 Annotation: Subtype: Link Rect: 403, 352, 415, 361 ActionDest: 102 Annotation: Subtype: Link Rect: 514, 252, 521, 261 ActionDest: 99 Annotation: Subtype: Link Rect: 521, 252, 528, 261 ActionDest: 99 Annotation: Subtype: Link Rect: 529, 252, 541, 261 ActionDest: 102 Annotation: Subtype: Link Rect: 388, 214, 400, 223 ActionDest: 99 Annotation: Subtype: Link Rect: 401, 214, 413, 223 ActionDest: 102 Annotation: Subtype: Link Rect: 544, 189, 556, 198 ActionDest: 102 Annotation: Subtype: Link Rect: 204, 139, 216, 148 ActionDest: 102 Annotation: Subtype: Link Rect: 344, 126, 356, 135 ActionDest: 102 Annotation: Subtype: Link Rect: 218, 101, 230, 110 ActionDest: 102 Annotation: Subtype: Link Rect: 365, 76, 377, 85 ActionDest: 102 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 374, 710, 386, 719 ActionDest: 99 Annotation: Subtype: Link Rect: 387, 710, 399, 719 ActionDest: 102 Annotation: Subtype: Link Rect: 399, 710, 411, 719 ActionDest: 102 Annotation: Subtype: Link Rect: 412, 710, 424, 719 ActionDest: 102 Annotation: Subtype: Link Rect: 424, 710, 436, 719 ActionDest: 102 Annotation: Subtype: Link Rect: 437, 710, 449, 719 ActionDest: 102 Annotation: Subtype: Link Rect: 326, 572, 337, 581 ActionDest: 99 Annotation: Subtype: Link Rect: 313, 510, 324, 519 ActionDest: 102 Annotation: Subtype: Link Rect: 328, 509, 339, 519 ActionDest: 102 Annotation: Subtype: Link Rect: 420, 497, 432, 506 ActionDest: 102 Annotation: Subtype: Link Rect: 268, 372, 275, 380 ActionDest: 99 Annotation: Subtype: Link Rect: 276, 371, 283, 380 ActionDest: 99 Annotation: Subtype: Link Rect: 283, 371, 295, 380 ActionDest: 102 Annotation: Subtype: Link Rect: 534, 296, 546, 305 ActionDest: 99 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 338, 514, 376, 525 Annotation: Subtype: Link Rect: 382, 514, 418, 525 Annotation: Subtype: Link Rect: 520, 503, 557, 514 Annotation: Subtype: Link Rect: 59, 492, 95, 502 Annotation: Subtype: Link Rect: 104, 469, 141, 479 Annotation: Subtype: Link Rect: 147, 469, 183, 479 Annotation: Subtype: Link Rect: 177, 446, 215, 456 Annotation: Subtype: Link Rect: 396, 411, 434, 422 Annotation: Subtype: Link Rect: 239, 388, 276, 399 Annotation: Subtype: Link Rect: 175, 353, 212, 364 Annotation: Subtype: Link Rect: 500, 330, 537, 341 Annotation: Subtype: Link Rect: 360, 307, 397, 318 Annotation: Subtype: Link Rect: 227, 284, 265, 295 Annotation: Subtype: Link Rect: 239, 261, 276, 272 Annotation: Subtype: Link Rect: 437, 249, 475, 260 Annotation: Subtype: Link Rect: 481, 249, 517, 260 Annotation: Subtype: Link Rect: 339, 226, 376, 237 Annotation: Subtype: Link Rect: 382, 226, 418, 237 Annotation: Subtype: Link Rect: 519, 203, 557, 214 Annotation: Subtype: Link Rect: 59, 193, 95, 203 Annotation: Subtype: Link Rect: 217, 169, 255, 180 Annotation: Subtype: Link Rect: 127, 147, 164, 157 Annotation: Subtype: Link Rect: 113, 124, 151, 134 Annotation: Subtype: Link Rect: 493, 111, 530, 122 Annotation: Subtype: Link Rect: 519, 77, 557, 88 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 370, 722, 408, 733 Annotation: Subtype: Link Rect: 104, 699, 141, 710 Annotation: Subtype: Link Rect: 147, 699, 183, 710 Annotation: Subtype: Link Rect: 269, 676, 307, 687 Annotation: Subtype: Link Rect: 313, 676, 349, 687 Annotation: Subtype: Link Rect: 519, 583, 557, 594 Annotation: Subtype: Link Rect: 418, 549, 456, 560 Annotation: Subtype: Link Rect: 356, 526, 394, 537 Annotation: Subtype: Link Rect: 59, 504, 96, 514 Annotation: Subtype: Link Rect: 352, 480, 389, 491 Annotation: Subtype: Link Rect: 59, 446, 96, 456 Annotation: Subtype: Link Rect: 218, 422, 255, 433 Annotation: Subtype: Link Rect: 292, 388, 330, 399 Annotation: Subtype: Link Rect: 336, 388, 372, 399 Annotation: Subtype: Link Rect: 437, 376, 474, 387 Annotation: Subtype: Link Rect: 481, 376, 517, 387 Annotation: Subtype: Link Rect: 59, 343, 96, 353 Annotation: Subtype: Link Rect: 102, 343, 138, 353 Checksum: b6a3100f Type: CRC32 Checksum: 9bb72e8c0d57b480025e4a8549680d78 Type: MD5 Checksum: 6411d89f7f1e1f324de24d01fa0f84eb5e20d00f Type: SHA-1 Checksum: c82ff87dda4adcef6645247288cb3db8f43d311d13a97f16161f5121faca0497 Type: SHA-256