Pneumococcal Meningitis in Adults: Clinical-Epidemiological and Diagnostic Aspects

Abstract

Relevance. Foreign and domestic authors notice that over the past thirty years there has been a significant reduction in the incidence of meningococcal infection, in contrast to bacterial meningitis not meningococcal etiology. S. pneumoniae occupies one of the leading places in the etiological structure of bacterial meningitis in the Russian Federation The purpose is of substantiation of the complex approach to the diagnosis of pneumococcal meningitis in adults, taking into account the clinical and epidemiological features of the disease and highly sensitive laboratory tests Materials and methods. Was conducted a retrospective analysis of 38 case histories of patients who were hospitalized at the Krasnoyarsk Interdistrict Clinical Emergency Hospital named after NS Karpovich with bacterial meningitis during 2015 to 2017. Results. Among those hospitalized with the diagnosis of «bacterial meningitis» the leading role in the etiology of the disease belonged to Streptococcus pneumoniae (55.2%), in other cases: Staphylococcus aureus, Streptococcus spp, fungi of the genus Candida spp., E. coli, Neisseria meningitidis, Cryptococcus spp., Some bacteria were detected in associations with other bacterial species or viruses, in 7.8% cases the pathogen was not detected. Conclusion. Microbiological diagnosis of bacterial meningitis requires the use of a set of methods that include not only microscopic, bacteriological and serological (latex agglutination) studies, but also PCR detection of pathogenic microorganisms in the cerebrospinal fluid, who diagnostic value is 46.4%.