Etiology and Clinical Features of Bacterial Meningitis in Adults at National Hospital for Tropical Diseases during 2015-2018.

Abstract

To evaluate the etiology and clinical features of bacterial meningitis (BM) in adults during 2015-2018 in Vietnam, a retrospective study using 102 patients was performed at the National Hospital of Tropical Diseases. BM occurred throughout the year, peaking in July-September. A total of 80.4% BM patients were males over 40 years old. The proportion of patients with underlying diseases was 41.2% and those in contact with pigs or pork products was 30.4%. Common manifestations include stiff neck, Kernig's sign, headache, fever/hypothermia, and altered consciousness. The cerebrospinal fluid (CSF) had high protein concentration (median: 3.2 g/L, range: 1.3-6.2) and leukocytes (median: 1,312 cell/mm3, range: 234-2,943). Moreover, 29.4% meningitis cases were associated with septicemia. Streptococcus suis was the main cause (72.5%), followed by Pneumococcus (6.8%) and a few other bacteria. Factors associated with S. suis risk were male sex (OR: 8.29, 95% CI: 2.83-24.33), over 40 years old (OR: 3.55, 95% CI: 1.28-9.87), drinking habits (OR: 3.78, 95% CI: 1.03-13.72), headache (OR: 6.19, 95% CI: 2.17-17.65), fever/hypothermia (OR: 5.17, 95% CI: 1.97-13.56) and ≥2.0 ng/mL procalcitonin (OR: 2.72, 95% CI: 1.07-6.89). Education on S. suis and nosocomial infection prevention, as well as pneumococcal vaccination use, should be continued.