Table 1.
Characteristics of episodes of spontaneous meningitis due to gram-negative bacilli and those due to other pathogens*
| Characteristics | Gram-negative bacillary meningitis (n = 40) | Other causes of meningitis (n = 405) | P value |
|---|---|---|---|
| Male sex |
23/40 (57.5) |
183/393 (46.6) |
0.187 |
| Age – years, median (IQR) |
64 (17) |
50 (41) |
< 0.001 |
| Comorbid conditions |
29/40 (72.5) |
173/403 (42.9) |
<0.001 |
| • Cancer |
8/40 (20.0) |
41/403 (10.2) |
0.067 |
| • Diabetes mellitus |
7/40 (17.5) |
45/403 (11.2) |
0.298 |
| • Alcoholism |
6/40 (15.0) |
43/403 (10.7) |
0.425 |
| • Liver cirrhosis |
4/40 (10.0) |
17/403 (4.2) |
0.110 |
| Charlson comorbidity index ≥ 3 |
10/39 (25.6) |
50/399 (12.5) |
0.023 |
| Distant focus of infection |
31/40 (77.5) |
139/402 (34.6) |
<0.001 |
| • Urinary tract infection |
13/40 (32.5) |
2/405 (0.5) |
<0.001 |
| • Otitis or sinusitis |
4/40 (10.0) |
58/405 (14.3) |
0.452 |
| • Pneumonia |
2/40 (5.0) |
22/405 (5.4) |
1.000 |
| Route of acquisition |
|
|
|
| • Hospital-acquired (vs. community-acquired) |
9/40 (22.5) |
8/405 (2) |
<0.001 |
| Symptoms on presentation |
|
|
|
| • Fever |
37/40 (92.5) |
387/402 (96.3) |
0.217 |
| • Change in mental status |
29/40 (72.5) |
278/402 (69.2) |
0.661 |
| • Neck stiffness |
24/40 (60.0) |
330/400 (82.5) |
0.001 |
| • Triad of fever, neck stiffness, and change in mental status |
16/40 (40.0) |
231/401 (57.6) |
0.032 |
| • Headache |
22/40 (55.0) |
323/402 (80.3) |
<0.001 |
| • Nausea and/or vomiting |
18/40 (45.0) |
239/394 (60.7) |
0.055 |
| • Focal neurological deficits |
12/40 (30.0) |
74/402 (18.4) |
0.093 |
| • Coma |
6/40 (15) |
26/402 (6.5) |
0.057 |
| • Seizures |
5/40 (12.5) |
33/401 (8.2) |
0.371 |
| • Rash |
1/40 (2.5) |
148/402 (36.8) |
<0.001 |
| • Systolic blood pressure – mm Hg (SD) |
122 (31) |
126 (31) |
0.507 |
| • Diastolic blood pressure – mm Hg (SD) |
69 (22) |
75 (21) |
0.087 |
| CSF examination |
|
|
|
| • White-cell count, median (IQR) |
1650 (2886) |
1120 (2865) |
0.248 |
| ○ < 100/mm3 |
3/39 (7.7) |
54/395 (13.7) |
0.292 |
| ○ 100–999/mm3 |
9/39 (23.1) |
132/395 (33.4) |
0.188 |
| ○ > 999/mm3 |
27/39 (69.2) |
209/395 (52.9) |
0.051 |
| • Protein – g/liter, median (IQR) |
3.75 (4.32) |
3.48 (5.03) |
0.786 |
| • CSF: blood glucose ratio, median (IQR) |
0.13 (0.22) |
0.20 (0.34) |
0.448 |
| Positive blood culture |
27/40 (67.5) |
218/401 (54.4) |
0.111 |
| Blood white-cell count, median (IQR) |
17350 (13225) |
16650 (10800) |
0.258 |
| Thrombocyte count- platelets/mm3, median (IQR) |
175000 (173000) |
185000 (125000) |
0.196 |
| Neurological complications |
20/40 (50) |
121/402 (30.1) |
0.010 |
| • Impaired mental status |
16/40 (40) |
70/401 (17.5) |
0.001 |
| • Seizures |
9/40 (22.5) |
50/403 (12.4) |
0.073 |
| • Focal neurological deficits |
12/40 (30) |
81/402 (20.1) |
0.145 |
| Systemic complications |
24/40 (60) |
123/395 (31.1) |
<0.001 |
| • Septic shock |
15/40 (37.5) |
63/402 (15.7) |
0.001 |
| • Disseminated intravascular coagulation |
7/40 (17.5) |
40/399 (10) |
0.174 |
| • Acute respiratory failure |
15/40 (37.5) |
56/402 (13.9) |
<0.001 |
| • Acute kidney injury |
12/40 (30) |
51/401 (12.7) |
0.003 |
| Outcome |
|
|
|
| • Neurological sequelae |
3/19 (15.8) |
49/334 (14.7) |
0.894 |
| • In-hospital mortality | 21/40 (52.5) | 66/404 (16.3) | <0.001 |
CI = confidence interval; IQR = interquartile range; SD = standard deviation.
*Values are reported as no./no. evaluated (%), unless otherwise noted.