Mortality indicators in pneumococcal meningitis: therapeutic implications

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dc.contributor.authorErdem, Hakan
dc.contributor.authorElaldi, Nazif
dc.contributor.authorOztoprak, Nefise
dc.contributor.authorSengoz, Gonul
dc.contributor.authorAk, Oznur
dc.contributor.authorKaya, Selcuk
dc.contributor.authorInan, Asuman
dc.contributor.authorNayman-Alpat, Saygin
dc.contributor.authorUlu-Kilic, Aysegul
dc.contributor.authorPekok, Abdullah Umut
dc.contributor.authorGunduz, Alper
dc.contributor.authorGozel, Mustafa G.
dc.contributor.authorPehlivanoglu, Filiz
dc.contributor.authorYasar, Kadriye
dc.contributor.authorYilmaz, Hava
dc.contributor.authorHatipoglu, Mustafa
dc.contributor.authorCicek-Senturk, Gonul
dc.contributor.authorAkcam, Fusun Z.
dc.contributor.authorInkaya, Ahmet C.
dc.contributor.authorKazak, Esra
dc.contributor.authorSagmak-Tartar, Ayse
dc.contributor.authorTekin, Recep
dc.contributor.authorOzturk-Engin, Derya
dc.contributor.authorErsoy, Yasemin
dc.contributor.authorSipahi, Oguz Resat
dc.contributor.authorGuven, Tumer
dc.contributor.authorTuncer-Ertem, Gunay
dc.contributor.authorAlabay, Selma
dc.contributor.authorAkbulut, Ayhan
dc.contributor.authorBalkan, Ilker I.
dc.contributor.authorOncul, Oral
dc.contributor.authorCetin, Birsen
dc.contributor.authorDayan, Saim
dc.contributor.authorErsoz, Gulden
dc.contributor.authorKarakas, Ahmet
dc.contributor.authorOzgunes, Nail
dc.contributor.authorSener, Alper
dc.contributor.authorYesilkaya, Aysegul
dc.contributor.authorErturk, Ayse
dc.contributor.authorGundes, Sibel
dc.contributor.authorKarabay, Oguz
dc.contributor.authorSirmatel, Fatma
dc.contributor.authorTosun, Selma
dc.contributor.authorTurhan, Vedat
dc.contributor.authorYalci, Aysun
dc.contributor.authorAkkoyunlu, Yasemin
dc.contributor.authorAydin, Emsal
dc.contributor.authorDiktas, Husrev
dc.contributor.authorKose, Sukran
dc.contributor.authorUlcay, Asim
dc.contributor.authorSeyman, Derya
dc.contributor.authorSavasci, Umit
dc.contributor.authorLeblebicioglu, Hakan
dc.contributor.authorVahaboglu, Haluk
dc.date.accessioned2019-10-27T22:05:23Z
dc.date.available2019-10-27T22:05:23Z
dc.date.issued2014
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.en_US
dc.identifier.doi10.1016/j.ijid.2013.09.012en_US
dc.identifier.endpage19en_US
dc.identifier.issn1201-9712
dc.identifier.issn1878-3511
dc.identifier.pmid24211227en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage13en_US
dc.identifier.urihttps://doi.org/10.1016/j.ijid.2013.09.012
dc.identifier.urihttps://hdl.handle.net/11454/48400
dc.identifier.volume19en_US
dc.identifier.wosWOS:000329981700003en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Sci Ltden_US
dc.relation.ispartofInternational Journal of Infectious Diseasesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectStreptococcus pneumoniaeen_US
dc.subjectMeningitisen_US
dc.subjectMortalityen_US
dc.subjectPenicillinen_US
dc.subjectResistanceen_US
dc.subjectVancomycinen_US
dc.titleMortality indicators in pneumococcal meningitis: therapeutic implicationsen_US
dc.typeArticleen_US

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