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

Abstract

Background:The aim of the study was to determine the effect of chronic alcohol abuse on the course and outcome of bacterial meningitis (BM). Materials/methods:We analyzed records of patients with BM who were hospitalized between January 2010 and December 2017 in the largest neuroinfection center in Poland.Results: 340 adult patients (211 men and 129 women) were analyzed. Forty-five (13.2%) patients were alcoholics (39 men and 6 women). Compared to non-alcoholics, alcoholics were more likely to present with seizures (33.3% vs 12.6%, p<0.001), scored higher on the Sequential Organ Failure Assessment (SOFA) (median 3 vs 2, p<0.001) and lower on the Glasgow Coma Scale (GCS) (median 10 vs 12, p<0.001) and had worse outcome as measured by the Glasgow Outcome Score (GOS) (median 3 vs 5, p<0.001). Furthermore, alcoholics were less likely to complain of headache (23.3% vs 52.3%, p<0.001) and nausea/vomiting (11.4% vs 33.6%, p=0.005) and had lower concentration of glucose in cerebrospinal fluid (CSF) (median 0,58 mmol/L vs 1,97, p=0.025). In the multiple logistic regression analysis, alcoholism was independently associated with lower GCS (OR 0.716, 95% CI 0.523-0.980, p=0.036), presence of seizures (OR 4.580, 95% CI 1.065-19.706, p=0.041), male gender (OR 4.617, 95% CI 1.060-20.113, p=0.042) and absence of nausea/vomiting (OR 0.205, 95%CI 0.045-0.930, p=0.040). Furthermore, alcoholism (regression coefficient [-0.636], 95% CI [-1.21] -[-0.06], p=0.031), lower GCS score (regression coefficient 0.144, 95% CI 0.06-0.23, p=0.001) and higher urea blood concentration (regression coefficient [-0.052], 95% CI [-0.10] -[-0.01], p=0.018) were independently associated with worse outcome measured by GOS.Conclusions: Compared to non-alcoholics, chronic alcohol abusers are more likely to present with seizures, altered mental status, higher SOFA score and have an increased risk of unfavorable outcome. In multivariate analysis seizures and low GCS were independently 3 associated with alcoholism, while alcoholism was independently associated with worse outcome.

Association of Diabetes with Meningitis Infection Risks: A Systematic Review and Meta-Analysis

“…Terefore, other factors such as multiple operations, pre-existing comorbidities, intraoperative cerebrospinal fuid leaks, and endoscopic approach used in the surgery may be stronger correlates of meningitis [44,67]. Factors such as active/ passive smoking and alcohol abuse have also been noted as independent risk factors for meningitis [15,16,19].…”

“…Approximately 290,000 people lost their lives in 2015 due to meningitis infection [12]. However, the mortality rate may vary with geography, age, sex, smoking/alcoholism prevalence, and underlying acute/chronic medical conditions such as diabetes mellitus and cancer [1,4,[13][14][15][16]. If meningitis remains untreated, its fatality rate can exceed 70% (CDC, (accessed), 2022), with the general mortality rate being 30 and 7% for S. pneumoniae and N. meningitidis, respectively, in more developed countries [17,18].…”

“…For an example, Iles et al [19] found a signifcant association between high levels of passive exposure to tobacco smoke and bacterial meningitis in Australian children. In Poland, smoking was signifcantly associated with negative outcomes in people sufering from bacterial meningitis (BM) [16]. For example, alcoholism was associated with a lower Glasgow Coma Scale (GCS) (p � 0.036) and the presence of seizures (p � 0.041) [16].…”

“…In Poland, smoking was signifcantly associated with negative outcomes in people sufering from bacterial meningitis (BM) [16]. For example, alcoholism was associated with a lower Glasgow Coma Scale (GCS) (p � 0.036) and the presence of seizures (p � 0.041) [16].…”