TY - JOUR
T1 - Community-acquired Haemophilus influenzae meningitis in adults
AU - Chekrouni, Nora
AU - Koelman, Diederik L. H.
AU - Brouwer, Matthijs C.
AU - van der Ende, Arie
AU - van de Beek, Diederik
N1 - Funding Information: This work was supported by the Netherlands Organization for Health Research and Development (ZonMw; NWO-Vidi Grant [grant number 917.17.308 ] to M.C.B; NWO-Vici -Grant [grant number 918.19.627 to D. B.]); and the European Research Council (ERC starting grant to D. B.). The Netherlands Reference laboratory for bacterial Meningitis is supported by the National Institute of Public health and the Environmental Protection, Bilthoven. Funding Information: This work was supported by the Netherlands Organization for Health Research and Development (ZonMw; NWO-Vidi Grant [grant number 917.17.308] to M.C.B; NWO-Vici-Grant [grant number 918.19.627 to D. B.]); and the European Research Council (ERC starting grant to D. B.). The Netherlands Reference laboratory for bacterial Meningitis is supported by the National Institute of Public health and the Environmental Protection, Bilthoven. NC contributed to data gathering, data analysis, data interpretation and writing the first draft of the manuscript. DK contributed to data gathering, data interpretation and critique of the report. MCB contributed to data interpretation, review and critique of the report. AvdE contributed to review and critique of the report. DvdB contributed to study design, data gathering, data analysis, data interpretation, review, and critique of the report. Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Background: Haemophilus influenzae is an uncommon cause of meningitis in adults. Methods: We analyzed episodes of community-acquired H. influenzae meningitis in adults included in a prospective nationwide cohort study in the Netherlands. Results: From 2006 to July 2018, 82 of 2272 (4%) bacterial meningitis episodes were caused by H. influenzae (mean annual incidence 0.5 patients per 1,000,000). Median age was 61 years (IQR 46–68), and 48 episodes (59%) occurred in woman. Predisposing factors were otitis and/or sinusitis in 33 of 76 patients (49%), immunocompromising conditions in 19 of 75 patients (25%) and cerebrospinal fluid leak in 13 of 79 patients (17%). Serotyping showed 63 of 80 isolates (79%) were non-typeable (NTHi). Three patients (4%) died and 14 patients (17%) had an unfavorable outcome (Glasgow Outcome Scale score < 5 at discharge). Pneumonia (odds ratio [OR] 5.8, 95% confidence interval [95%CI] 1.1–30.8), presence of immunocompromising conditions (OR 6.0, 95%CI 1.5–24.4), and seizures on admission (OR 10.7, 95%CI 1.6–72.8) were associated with an unfavorable outcome, while NTHi was associated with a favorable outcome (OR 5.6, 95%CI 1.6–19.5). Conclusion: H. influenzae is an uncommon cause of adult bacterial meningitis patients mainly causing disease in those with predisposing factors, such as CSF leakage, ENT infections, and immunocompromised state. In adult patients the majority of H. influenzae meningitis is caused by non-typeable strains.
AB - Background: Haemophilus influenzae is an uncommon cause of meningitis in adults. Methods: We analyzed episodes of community-acquired H. influenzae meningitis in adults included in a prospective nationwide cohort study in the Netherlands. Results: From 2006 to July 2018, 82 of 2272 (4%) bacterial meningitis episodes were caused by H. influenzae (mean annual incidence 0.5 patients per 1,000,000). Median age was 61 years (IQR 46–68), and 48 episodes (59%) occurred in woman. Predisposing factors were otitis and/or sinusitis in 33 of 76 patients (49%), immunocompromising conditions in 19 of 75 patients (25%) and cerebrospinal fluid leak in 13 of 79 patients (17%). Serotyping showed 63 of 80 isolates (79%) were non-typeable (NTHi). Three patients (4%) died and 14 patients (17%) had an unfavorable outcome (Glasgow Outcome Scale score < 5 at discharge). Pneumonia (odds ratio [OR] 5.8, 95% confidence interval [95%CI] 1.1–30.8), presence of immunocompromising conditions (OR 6.0, 95%CI 1.5–24.4), and seizures on admission (OR 10.7, 95%CI 1.6–72.8) were associated with an unfavorable outcome, while NTHi was associated with a favorable outcome (OR 5.6, 95%CI 1.6–19.5). Conclusion: H. influenzae is an uncommon cause of adult bacterial meningitis patients mainly causing disease in those with predisposing factors, such as CSF leakage, ENT infections, and immunocompromised state. In adult patients the majority of H. influenzae meningitis is caused by non-typeable strains.
KW - Capsular serotype
KW - Clinical characteristics
KW - Community-acquired bacterial meningitis
KW - Haemophilus influenzae
KW - Prospective cohort study
UR - http://www.scopus.com/inward/record.url?scp=85103947848&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jinf.2021.03.016
DO - https://doi.org/10.1016/j.jinf.2021.03.016
M3 - Article
C2 - 33774020
SN - 0163-4453
VL - 82
SP - 145
EP - 150
JO - Journal of Infection
JF - Journal of Infection
IS - 5
ER -