Epidemiology of adult staphylococcal meningitis in southern Taiwan: a clinical comparison of Staphylococcus aureus infection and coagulase-negative staphylococcal infection

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  • Chang Wen-Neng
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Lu Cheng-Hsien
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Huang Chi-Ren
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Chuang Yao-Chung
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Tsai Nai-Wen
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Chen Shu-Fang
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Chang Chiung-Chih
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Wang Hung-Chen
    Department of Neurosurgery , Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan
  • Chien Chun-Chih
    Department of Clinical Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Tainwan
  • Wu Jiunn-Jong
    Department of Medical Technology, Medical College, National Cheng Kung University, Taiwan

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  • Epidemiology of Adult Staphylococcal Meningitis in Southern Taiwan: a Clinical Comparison of <i>Staphylococcus aureus</i> Infection and Coagulase-Negative Staphylococcal Infection

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<p>The clinical and laboratory characteristics of 38 staphylococcal adult bacterial meningitis (ABM) cases (19 Staphylococcus aureus infections and 19 coagulase-negative staphylococcal [CoNS] infections), collected over a period of 6.5 years (July 1999 - December 2005; total ABM cases = 181) were analyzed. The results were compared with those of our previous study (January 1986 - June 1999; total ABM cases = 202: monomicrobial infection = 180, mixed infection = 22, staphylococcal infection = 27). The 38 staphylococcal meningitis cases were 21 men and 17 women. Fever and altered consciousness were the leading clinical manifestations. A preceding postneurosurgical state was noted in 12 of the 19 S. aureus infections and all 19 CoNS infections. The ages of onset and mortality rates of S. aureus infection and CoNS infection were 58.21 ± 13.05 years and 36.8% (7/19), and 44.16 ± 17.57 and 5.3% (1/19), respectively. Eleven of the 19 implicated S. aureus strains and 18 of the 19 implicated CoNS strains were mecA gene-positive and methicillin-resistant; all the strains retained their susceptibility to linezolid. The therapeutic results showed a mortality rate of 21% (8/38). This study revealed an increase of methicillin-resistant, postneurosurgical staphylococcal infection in ABM. Patients with CoNS infection had a younger age at onset and a lower mortality rate.</p>

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