Table 1.
Demographic and Clinical Characteristics of Vietnamese Patients With Central Nervous System Infections
| General Characteristics | CNS Infections (n = 330) | Routine Positive Specimens (n = 48) | Routine Negative Specimens (n = 282) | P Value | FAME-positive Specimens (n = 33) | FAME-negative Specimens (n = 297) | P Value |
|---|---|---|---|---|---|---|---|
| Demographics | |||||||
| Age (mean ± SD) | 54 ± 19 | 53 ± 18 | 55 ± 19 | .47 | 53 ± 18 | 55 ± 19 | .62 |
| Male sex—no. (%) | 225 (68) | 37 (77) | 188 (67) | .15 | 24 (73) | 201 (68) | .56 |
| Underlying condition—no. (%) | |||||||
| Hypertension | 90 (27) | 8 (17) | 82 (29) | .07 | 10 (30) | 80 (27) | .68 |
| Diabetes | 62 (19) | 2 (4) | 60 (21) | .005 | 4 (12) | 58 (20) | .30 |
| Cardiac disease | 19 (6) | 1 (2) | 18 (6) | .33a | 0 (0) | 19 (6) | .24a |
| Alcoholism | 17 (5) | 8 (17) | 9 (3) | <.001a | 2 (6) | 15 (5) | .68a |
| Chronic liver disease | 18 (6) | 4 (8) | 14 (5) | .31a | 1 (3) | 17 (6) | 1a |
| Chronic lung disease | 17 (5) | 3 (6) | 14 (5) | .72a | 3 (9) | 14 (5) | .24a |
| Kidney disease | 15 (5) | 2 (4) | 13 (5) | 1a | 1 (3) | 14 (5) | 1a |
| Immunosuppressive drugs | 13 (4) | 1 (2) | 12 (4) | .7a | 1 (3) | 12 (4) | 1a |
| Cancer | 13 (4) | 0 (0) | 13 (5) | .23a | 0 (0) | 13 (4) | .38a |
| HIV-positive | 9 (3) | 1 (2) | 8 (3) | 1a | 0 (0) | 9 (3) | .61a |
| Risk factor—no. (%) | |||||||
| Post neurosurgery | 29 (9) | 5 (10) | 24 (9) | .59a | 3 (9) | 26 (9) | 1a |
| Head trauma | 31 (9) | 2 (4) | 29 (10) | .28a | 3 (9) | 28 (9) | 1a |
| CSF shunt | 5 (2) | 0 (0) | 5 (2) | 1a | 0 (0) | 5 (2) | 1a |
| Clinical features—no. (%) | |||||||
| Fever (>37.5 °C) | 273 (83) | 46 (96) | 227 (81) | .009 | 32 (97) | 241 (81) | .02 |
| Headache | 221 (67) | 37 (77) | 184 (65) | .11 | 27 (82) | 194 (65) | .06 |
| Neck stiffness | 207 (63) | 40 (83) | 167 (59) | .001 | 27 (82) | 180 (61) | .02 |
| Nausea/vomiting | 99 (30) | 21 (44) | 78 (8) | .025 | 13 (39) | 86 (29) | .21 |
| Seizure | 29 (9) | 3 (6) | 26 (9) | .78a | 1 (3) | 28 (9) | .34a |
| Focal neurologic deficits | 20 (6) | 4 (8) | 16 (6) | .51a | 2 (6) | 18 (6) | 1a |
| Glasgow Coma Score | 13 ± 2 | 12 ± 2 | 13 ± 2 | <.001 | 13 ± 2 | 13 ± 2 | .62 |
| < 14 (indicating altered mental status)—no. (%) | 142 (43) | 36 (75) | 106 (38) | <.001 | 19 (58) | 123 (41) | .08 |
| At least 2 of 4 symptoms (headache, fever, stiff neck, and altered mental status) | 273 (83) | 45 (94) | 228 (81) | .03 | 32 (97) | 241 (81) | .02 |
| Outcome | |||||||
| Death | 32 (10) | 4 (8) | 28 (10) | 3 (9) | 29 (10) | ||
| Vegetative state | 29 (9) | 10 (21) | 19 (7) | 3 (9) | 26 (9) | ||
| Severe disability | 64 (19) | 8 (17) | 56 (20) | 4 (12) | 60 (20) | ||
| Moderate disability | 62 (19) | 5 (10) | 57 (20) | 5 (15) | 57 (19) | ||
| Mild or no disability | 143 (43) | 21 (44) | 122 (43) | 18 (55) | 125 (42) | ||
| Cerebrospinal fluid | |||||||
| Cell count (cells/mm3)b | |||||||
| mean ± SD | 1032 ± 5897 | 4898 ± 14437 | 376 ± 1726 | <.001 | 3315 ± 7751 | 761 ± 5601 | .007 |
| Pleocytosis of 5 cells/mm3 | 225 (69) | 42 (89) | 183 (66) | .001 | 29 (88) | 196 (67) | .015 |
| Pleocytosis of 10 cells/mm3 | 175 (54) | 39 (83) | 136 (49) | <.001 | 26 (79) | 149 (51) | .003 |
| Protein (g/L)c | |||||||
| Mean ± SD | 1.56 ± 2.78 | 3.54 ± 4.01 | 1.22 ± 2.36 | <.001 | 2.38 ± 2.36 | 1.47 ± 2.82 | .07 |
| Abnormal protein | 307 (94) | 48 (100) | 259 (93) | .089a | 33 (100) | 274 (94) | .24a |
| Glucose (mmol/L)c | |||||||
| Mean ± SD | 4.16 ± 2.96 | 2.11 ± 1.85 | 4.50 ± 2.98 | <.001 | 3.35 ± 3.85 | 4.25 ± 2.84 | .09 |
| Abnormal glucose | 188 (58) | 36 (77) | 152 (54) | .005 | 23 (70) | 165 (56) | .10 |
Abbreviation: CSF, cerebrospinal fluid; FAME, BioFire FilmArray Meningitis/Encephalitis.
aFisher exact test.
bThe CSF leukocyte count was determined in 324 patients; CSF specimens from 6 patients had too many leukocytes for an exact count to be performed (missing values, n = 6 for FAME negative, n = 1 for routine test positive and n = 5 for routine test negative).
cThe protein and glucose levels in the CSF were determined in 326 patients; the remaining 4 CSF samples were not measured (missing values, n = 4 for FAME negative and n = 4 for routine test negative).