Etiology and Clinical Features of Bacterial Meningitis in Adults at National Hospital for Tropical Diseases during 2015–2018

Abstract

To evaluate the etiology and clinical features of bacterial meningitis (BM) in adults during 2015–2018 in Vietnam, a retrospective study using 102 patients was performed at the National Hospital of Tropical Diseases. BM occurred throughout the year, peaking in July–September. A total of 80.4% BM patients were males over 40 years old. The proportion of patients with underlying diseases was 41.2% and those in contact with pigs or pork products was 30.4%. Common manifestations include stiff neck, Kernig’s sign, headache, fever/hypothermia, and altered consciousness. The cerebrospinal fluid (CSF) had high protein concentration (median: 3.2 g/L, range: 1.3–6.2) and leukocytes (median: 1,312 cell/mm³, range: 234–2,943). Moreover, 29.4% meningitis cases were associated with septicemia. Streptococcus suis was the main cause (72.5%), followed by Pneumococcus (6.8%) and a few other bacteria. Factors associated with S. suis risk were male sex (OR: 8.29, 95% CI: 2.83–24.33), over 40 years old (OR: 3.55, 95% CI: 1.28–9.87), drinking habits (OR: 3.78, 95% CI: 1.03–13.72), headache (OR: 6.19, 95% CI: 2.17–17.65), fever/hypothermia (OR: 5.17, 95% CI: 1.97–13.56) and ≥2.0 ng/mL procalcitonin (OR: 2.72, 95% CI: 1.07–6.89). Education on S. suis and nosocomial infection prevention, as well as pneumococcal vaccination use, should be continued.