Risk Factors and Comorbidity in Patients with Bacterial Meningitis

Abstract

Introduction. Bacterial meningitis is a severe disease with high mortality and frequent residual neurological sequelae. It is associated with multiple risk factors. The aim of the study was to establish the main risk factors associated with bacterial meningitis and to outline the incidence of chronic diseases in patients with bacterial meningitis and their relationship to the patients’ age and etiology of meningitis, if any. Materials and methods. The study included 90 patients with bacterial meningitis admitted to the Clinic of Infectious Diseases, University Hospital “Sv. Georgi” – Plovdiv during the period January 1, 2016 – September 30, 2019. Epidemiological analyses, clinical examinations, laboratory and microbiological tests, and statistical methods were used. Results. A total of 76.8% of patients had concomitant conditions: cardiovascular diseases (38.9%), diabetes mellitus (16.7%), immunosuppression (16.7%), liver diseases (11.1%), pulmonary diseases (10%), neoplasms (7.8%), chronic kidney diseases (7.8%). The incidence of immunosuppression (p = 0.009), cardiovascular disease (p = 0.0001), and diabetes (p = 0.009) were significantly higher in adults compared to children. Risk factors were present in 37.8% of patients (44% in children and 35.4% in adults, p > 0.05), especially in patients with pneumococcal meningitis (47.1%). The main risk factor was otitis or sinusitis in the last 3 months before meningitis (17.8%), followed by head trauma (6.7%), alcoholism (6.2%), recurrent episode of meningitis (4.4%), nasal leakage of cerebrospinal fluid (3.3%), general surgery (3.3%), and splenectomy (2.2%). Conclusion. Elderly patients with meningitis had more frequent comorbidities than children, mostly cardiovascular diseases, diabetes, and immunosuppression. The highest incidence of chronic diseases was found in patients with listerial meningitis. Risk factors were found in both age groups.