Mortality indicators in pneumococcal meningitis: therapeutic implications

Erdem, Hakan; Elaldı, Nazif; Öztoprak, Nefise; Şengöz, Gönül; Ak, Öznur; Kaya, Selçuk; İnan, Asuman; Nayman-Alpat, Saygın; Ulu-Kılıç, Ayşegül; Pekok, Abdullah Umut; Gündüz, Alper; Gözel, Mustafa Gökhan; Pehlivanoğlu, Filiz; Yaşar, Kadriye Kart; Yılmaz, Hava; Hatipoğlu, Mustafa; Çiçek-Şentürk, Gönül; Akçam, Füsun Zeynep; İnkaya, Ahmet Çağkan; Kazak, Esra; Sağmak-Tartar, Ayşe; Tekin, Recep; Öztürk-Engin, Derya; Ersoy, Yasemin; Sıpahi, Oğuz Reşat; Güven, Tümer; Tuncer-Ertem, Gunay; Alabay, Selma; Akbulut, Ayhan; Balkan, İ̇lker İnanç; Öncül, Oral; Çetin, Birsen; Dayan, Saim; Ersöz, Gülden; Karakaş, Ahmet; Özgüneş, Nail; Şener, Alper; Yeşilkaya, Ayşegül; Ertürk, Ayşe; Gündeş, Sibel; Karabay, Oğuz; Sırmatel, Fatma; Tosun, Selma; Turhan, Vedat; Yalçı, Aysun; Akkoyunlu, Yasemin; Aydin, Emsal; Diktaş, Hüsrev; Köse, Şükran; Ülçay, Asım; Seyman, Derya; Savasci, Umit; Leblebicioğlu, Hakan; Vahaboğlu, Haluk

doi:10.1016/j.ijid.2013.09.012

Cited by 45 publications

(44 citation statements)

References 48 publications

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“…On the other hand, the data in the literature related to the efficacy of treatment in HSV-2 meningitis are rather unclear (25,26).The host parameters directly affect the course of central nervous system (CNS) infections. In different types of CNS infections, increasing age and lower GCS scores have long been known to be associated with poor outcomes (27)(28)(29). Our HME data were also in accordance with those regarding other infectious CNS disorders and with the initial reports of adult HME series (10,18,19).…”

Section: Discussionsupporting

confidence: 89%

Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis

Erdem

Çağ

Öztürk-Engin

et al. 2015

Antimicrob Agents Chemother

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Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.

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Section: Discussionsupporting

confidence: 89%

Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis

Erdem

Çağ

Öztürk-Engin

et al. 2015

Antimicrob Agents Chemother

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“…Pnömokoklardaki antibiyotik direnci incelendiğinde birçok ülkede 1980'li yıllardan sonra penisilin dirençli suşların her geçen gün artış gösterdiği saptanmaktadır (16)(17)(18)(19). S. pneumoniae'de bazı ülkelerde kontrollü antibiyotik kullanımı başta olmak üzere bazı önlemler alınarak direncin artışı kontrol altına alınmış, direnç düşüş gösterdiği gözlenmiştir (20)(21)(22) (23).…”

Section: Discussionunclassified

Characteristics of Streptococcus Strains Isolated From Clinical Specimens Other Than Throat Culture and Characteristics of Streptococcal Infections

Ünlü¹,

Özgenç²,

Ari³

et al. 2018

Haseki

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ÖzAmaç: Bu çalışmada boğaz dışı kültürlerde Streptococcus spp. üremesi olan olguların laboratuvar ve klinik özelliklerinin değerlendirilmesi amaçlanmıştır. Results: Streptococcus strains types were determined as follows; group A (9-5.6%), group B (64-39.7%), group C (2-1.2%), group D (2-1.2%), group G (2-1.2%), viridans (57-32.2%), and Streptococcus pneumonia (24-14,9%). Most frequently observed infections were urinary system infections (52-32.2%), skin and soft tissue infections (48-29.8%) and pulmonary infections (25-15.5%). In 87 (54%) of patients, there was more than one comorbid condition. While all group A Streptococcus pyogenes strains were susceptible to penicillin, 13% of Streptococcus pneumonia were resistant to penicillin and 36.3% were resistant to macrolides. Mortality was observed in eight patients. Conclusion:Invasive streptococcal infections may cause serious mortality and morbidity especially in patients with comorbid conditions. Early detection and appropriate antimicrobial therapy are most important parameters for the management of streptococcal infections.

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“…ID-IRI has produced bulk of information on pneumococcal meningitis [4], brucellar meningitis [5], tuberculous meningitis [6,7], and herpetic meningoencephalitis [8]. Among these CNS infection studies [5][6][7][8] are the largest case series ever reported in the literature.…”

Section: Brief Reportmentioning

confidence: 99%

Other Foci of Infections in Community Acquired Central Nervous System Infections

Erdem¹,

Çağ²,

Şenbayrak³

et al. 2017

J Meningitis

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The data related to the distribution of other focal infections in central nervous system (CNS) infection patients is inconsistent in medical literature. Infectious Diseases International Research Initiative (ID-IRI) has been carrying on multicenter and multinational studies since 2008 and provided bulk of information on pneumococcal meningitis, brucellar meningitis, tuberculous meningitis, and herpetic meningoencephalitis as the largest case series in the literature. In this study, the databases of ID-IRI studies were reanalyzed and one fourth of pneumococcal and brucellar meningitis patients, and slightly less than half of tuberculous meningitis patients had another focal involvement out of CNS. Herpetic meningoencephalitis had only 7% coexistent other focal involvement. Consequently, the treating clinician should not undervalue the presence of another site of involvement in a CNS infection patient. Hence, diagnostic and therapeutic interventions for other site of involvement in due course of CNS infectious diseases should seriously be taken into consideration.

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Mortality indicators in pneumococcal meningitis: therapeutic implications

Cited by 45 publications

References 48 publications

Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis

Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis

Characteristics of Streptococcus Strains Isolated From Clinical Specimens Other Than Throat Culture and Characteristics of Streptococcal Infections

Other Foci of Infections in Community Acquired Central Nervous System Infections

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