ETIOLOGY AND CLINICAL FEATURES OF BACTERIAL MENINGITIS IN ADULTS AT NATIONAL HOSPITAL FOR TROPICAL DISEASES, PERIOD 2015 – 2018

Abstract

To evaluate the etiology and clinical features of bacterial meningitis (BM) in adults during the period 2015-2018 in Vietnam, a retrospective study was performed at the National Hospital of Tropical Diseases. 102 patients were identified. BM occurred year-round, peaked in July - September, male was 80.4%, over 40 years old accounted for 80.4%. The proportion of patients with underlying diseases was 41.2%, contact with pigs or pork products was 30.4%. Common manifestations were stiff neck, kernig, headache, fever/hypothermia, and altered consciousness. The CSF showed high protein concentration (median 3.2 g/L, range 1.3 – 6.2), and leukocytes (median 1312 cell/mm3, range 234-2943). Meningitis associated with septicemia was 29.4%. Streptococcus suis still was the main cause (72.5%), followed by Pneumococcal (6.8%) and a few other causes. Factors associated with the risk of S. suis should be considered were male (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 Procalcitonin ≥ 2.0 ng/ml (OR: 2.72, 95% CI: 1.07-6.89). Education on prevention of S. suis and nosocomial infections should continue, as well as the use of pneumococcal vaccination.