Chronic alcohol abuse affects the clinical course and outcome of community-acquired bacterial meningitis

Abstract

The aim of the study was to determine the effect of chronic alcohol abuse on the course and outcome of bacterial meningitis (BM). We analyzed records of patients with BM who were hospitalized between January 2010 and December 2017 in the largest neuroinfection center in Poland. Out of 340 analyzed patients, 45 (13.2%) were alcoholics. Compared with non-alcoholics, alcoholics were more likely to present with seizures (p < 0.001), scored higher on the Sequential Organ Failure Assessment (SOFA) (p = 0.002) and lower on the Glasgow Coma Scale (GCS) (p < 0.001), and had worse outcome as measured by the Glasgow Outcome Score (GOS) (p < 0.001). Furthermore, alcoholics were less likely to complain of headache (p < 0.001) and nausea/vomiting (p = 0.005) and had lower concentration of glucose in cerebrospinal fluid (CSF) (p = 0.025). In the multiple logistic regression analysis, alcoholism was associated with lower GCS (p = 0.036), presence of seizures (p = 0.041), male gender (p = 0.042), and absence of nausea/vomiting (p = 0.040). Furthermore, alcoholism (p = 0.031), lower GCS score (p = 0.001), and higher blood urea concentration (p = 0.018) were independently associated with worse outcome measured by GOS. Compared with non-alcoholics, chronic alcohol abusers are more likely to present with seizures, altered mental status, and higher SOFA score and have an increased risk of unfavorable outcome. In multivariate analysis, seizures and low GCS were independently associated with alcoholism, while alcoholism was independently associated with worse outcome.Electronic supplementary materialThe online version of this article (10.1007/s10096-019-03661-5) contains supplementary material, which is available to authorized users.

Streptococcus suis meningitis in China: a case report

“…This may lead to increased susceptibility to pathogenesis by infections such as bacterial meningitis ( 23 ). Alcoholism was independently associated with poor outcomes, such as a lower GCS score in meningitis ( 24 ). A previous study demonstrated that alcohol consumption can decrease the trans-epithelial electrical resistance (TER) value, thereby promoting the intestinal translocation of S. suis to the blood and brain in a mouse model ( 25 ).…”