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Abstract

We collected 540 patients with adult bacterial meningitis (ABM) from 1986-2015, of whom 167 were �65 years. Of these 167 elderly patients, 82 had post-neurosurgical infections and 85 had spontaneous infections. The 82 elderly ABM patients with post-neurosurgical infections included 48 men and 34 women with a median age of 71 years (range: 65-84 years). The major clinical presentations were fever (80.5%), altered consciousness (50.0%), hydrocephalus (43.9%), seizure (24.4%) and septic shock (15.9%). Of the implicated pathogens, staphylococcal species (spp.) were the most common (31.7%), followed by Acinetobacter spp. (12.2%), Enterobacter spp. (7.3%), Pseudomonas spp. (7.3%), Enterococcus faecalis (7.3%) and Escherichia coli (6.1%). The implicated staphylococcal spp. had a high rate of non-susceptibility to methicillin (84.6%), and the implicated Acinetobacter spp. and Enterobacter spp. had non-susceptible rates to ceftazidime of 60% and 50%, respectively. The mortality rate was 28.1%, and septic shock was the most significant prognostic factor. As the conclusion, elderly patients accounted for 30.9% of all cases of ABM, of whom 49.1% had post-neurosurgical ABM. The clinical characteristics of the elderly patients with post-neurosurgical ABM were non-specific, and cerebrospinal fluid studies were needed to confirm the diagnosis. The mortality rate of this group of patients was high, and septic shock was an important prognostic factor. The clinical and laboratory features and therapeutic outcomes were different between the elderly patients with post-neurosurgical and spontaneous ABM.

Biography

Lee Jun Jun has completed her Medical Training at Tapei Medical University and Resident Training at Kaohsiung Chung Gung Memorial Hospital.
Email:killerclaire@gmail.com