Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study: a prospective cohort study (2024)

Bijlsma, M. W., Brouwer, M. C., Kasanmoentalib, E. S., Kloek, A. T., Lucas, M. J., Tanck, M. W., van der Ende, A. (2016). Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study: a prospective cohort study. Lancet infectious diseases, 16(3), 339-347. https://doi.org/10.1016/S1473-3099(15)00430-2

Bijlsma, Merijn W. ; Brouwer, Matthijs C. ; Kasanmoentalib, E. Soemirien et al. / Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study : a prospective cohort study. In: Lancet infectious diseases. 2016 ; Vol. 16, No. 3. pp. 339-347.

@article{c87e3494774240a89536c9cfd6242146,

title = "Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study: a prospective cohort study",

abstract = "We studied causative pathogens, clinical characteristics, and outcome of adult community-acquired bacterial meningitis after the introduction of adjunctive dexamethasone treatment and nationwide implementation of paediatric conjugate vaccines. In this cohort study, we prospectively assessed adults (age >16 years) with community-acquired bacterial meningitis in the Netherlands, identified through the National Reference Laboratory for Bacterial Meningitis or individual physicians between Jan 1, 2006, and July 1, 2014. We identified independent predictors of an unfavourable outcome (Glasgow Outcome Scale score 1-4) by logistic regression. We assessed 1412 episodes of community-acquired bacterial meningitis. Incidence declined from 1·72 cases per 100,000 adults per year in 2007-08, to 0·94 per 100,000 per year in 2013-14. Streptococcus pneumoniae caused 1017 (72%) of 1412 episodes. Rates of adult bacterial meningitis decreased most sharply among pneumococcal serotypes included in paediatric conjugate vaccine, and in meningococcal meningitis. We found no evidence of serotype or serogroup replacement. The overall case fatality rate was 244 (17%) of 1412 episodes and unfavourable outcome occurred in 531 (38%) of 1412 episodes. Predictors of unfavourable outcome were advanced age, absence of otitis or sinusitis, alcoholism, tachycardia, lower score on the Glasgow Coma Scale, cranial nerve palsy, a cerebrospinal fluid white-cell count lower than 1000 cells per μL, a positive blood culture, and a high serum C-reactive protein concentration. Adjunctive dexamethasone was administered for 1234 (89%) of 1384 assessed episodes. The multivariable adjusted odds ratio of dexamethasone treatment for unfavourable outcome was 0·54 (95% CI 0·39-0·73). The incidence of adult bacterial meningitis has decreased substantially, which is partly explained by herd protection by paediatric conjugate vaccines. Adjunctive dexamethasone treatment was associated with substantially improved outcome. European Research Council, National Institute of Public Health and the Environment, European Union, Academic Medical Center, and Netherlands Organization for Health Research and Development",

keywords = "Adolescent, Adult, Aged, Anti-Inflammatory Agents/therapeutic use, Bacteria/classification, Cohort Studies, Community-Acquired Infections/drug therapy, Dexamethasone/therapeutic use, Female, Humans, Incidence, Male, Meningitis, Bacterial/drug therapy, Middle Aged, Netherlands/epidemiology, Odds Ratio, Serogroup, Time Factors, Treatment Outcome, Young Adult",

author = "Bijlsma, {Merijn W.} and Brouwer, {Matthijs C.} and Kasanmoentalib, {E. Soemirien} and Kloek, {Anne T.} and Lucas, {Marjolein J.} and Tanck, {Michael W.} and {van der Ende}, Arie and {van de Beek}, Diederik",

year = "2016",

month = mar,

doi = "https://doi.org/10.1016/S1473-3099(15)00430-2",

language = "English",

volume = "16",

pages = "339--347",

journal = "Lancet infectious diseases",

issn = "1473-3099",

publisher = "Lancet Publishing Group",

number = "3",

}

Bijlsma, MW, Brouwer, MC, Kasanmoentalib, ES, Kloek, AT, Lucas, MJ, Tanck, MW, van der Ende, A 2016, 'Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study: a prospective cohort study', Lancet infectious diseases, vol. 16, no. 3, pp. 339-347. https://doi.org/10.1016/S1473-3099(15)00430-2

Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study: a prospective cohort study. / Bijlsma, Merijn W.; Brouwer, Matthijs C.; Kasanmoentalib, E. Soemirien et al.
In: Lancet infectious diseases, Vol. 16, No. 3, 03.2016, p. 339-347.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study

T2 - a prospective cohort study

AU - Bijlsma, Merijn W.

AU - Brouwer, Matthijs C.

AU - Kasanmoentalib, E. Soemirien

AU - Kloek, Anne T.

AU - Lucas, Marjolein J.

AU - Tanck, Michael W.

AU - van der Ende, Arie

AU - van de Beek, Diederik

PY - 2016/3

Y1 - 2016/3

N2 - We studied causative pathogens, clinical characteristics, and outcome of adult community-acquired bacterial meningitis after the introduction of adjunctive dexamethasone treatment and nationwide implementation of paediatric conjugate vaccines. In this cohort study, we prospectively assessed adults (age >16 years) with community-acquired bacterial meningitis in the Netherlands, identified through the National Reference Laboratory for Bacterial Meningitis or individual physicians between Jan 1, 2006, and July 1, 2014. We identified independent predictors of an unfavourable outcome (Glasgow Outcome Scale score 1-4) by logistic regression. We assessed 1412 episodes of community-acquired bacterial meningitis. Incidence declined from 1·72 cases per 100,000 adults per year in 2007-08, to 0·94 per 100,000 per year in 2013-14. Streptococcus pneumoniae caused 1017 (72%) of 1412 episodes. Rates of adult bacterial meningitis decreased most sharply among pneumococcal serotypes included in paediatric conjugate vaccine, and in meningococcal meningitis. We found no evidence of serotype or serogroup replacement. The overall case fatality rate was 244 (17%) of 1412 episodes and unfavourable outcome occurred in 531 (38%) of 1412 episodes. Predictors of unfavourable outcome were advanced age, absence of otitis or sinusitis, alcoholism, tachycardia, lower score on the Glasgow Coma Scale, cranial nerve palsy, a cerebrospinal fluid white-cell count lower than 1000 cells per μL, a positive blood culture, and a high serum C-reactive protein concentration. Adjunctive dexamethasone was administered for 1234 (89%) of 1384 assessed episodes. The multivariable adjusted odds ratio of dexamethasone treatment for unfavourable outcome was 0·54 (95% CI 0·39-0·73). The incidence of adult bacterial meningitis has decreased substantially, which is partly explained by herd protection by paediatric conjugate vaccines. Adjunctive dexamethasone treatment was associated with substantially improved outcome. European Research Council, National Institute of Public Health and the Environment, European Union, Academic Medical Center, and Netherlands Organization for Health Research and Development

AB - We studied causative pathogens, clinical characteristics, and outcome of adult community-acquired bacterial meningitis after the introduction of adjunctive dexamethasone treatment and nationwide implementation of paediatric conjugate vaccines. In this cohort study, we prospectively assessed adults (age >16 years) with community-acquired bacterial meningitis in the Netherlands, identified through the National Reference Laboratory for Bacterial Meningitis or individual physicians between Jan 1, 2006, and July 1, 2014. We identified independent predictors of an unfavourable outcome (Glasgow Outcome Scale score 1-4) by logistic regression. We assessed 1412 episodes of community-acquired bacterial meningitis. Incidence declined from 1·72 cases per 100,000 adults per year in 2007-08, to 0·94 per 100,000 per year in 2013-14. Streptococcus pneumoniae caused 1017 (72%) of 1412 episodes. Rates of adult bacterial meningitis decreased most sharply among pneumococcal serotypes included in paediatric conjugate vaccine, and in meningococcal meningitis. We found no evidence of serotype or serogroup replacement. The overall case fatality rate was 244 (17%) of 1412 episodes and unfavourable outcome occurred in 531 (38%) of 1412 episodes. Predictors of unfavourable outcome were advanced age, absence of otitis or sinusitis, alcoholism, tachycardia, lower score on the Glasgow Coma Scale, cranial nerve palsy, a cerebrospinal fluid white-cell count lower than 1000 cells per μL, a positive blood culture, and a high serum C-reactive protein concentration. Adjunctive dexamethasone was administered for 1234 (89%) of 1384 assessed episodes. The multivariable adjusted odds ratio of dexamethasone treatment for unfavourable outcome was 0·54 (95% CI 0·39-0·73). The incidence of adult bacterial meningitis has decreased substantially, which is partly explained by herd protection by paediatric conjugate vaccines. Adjunctive dexamethasone treatment was associated with substantially improved outcome. European Research Council, National Institute of Public Health and the Environment, European Union, Academic Medical Center, and Netherlands Organization for Health Research and Development

KW - Adolescent

KW - Adult

KW - Aged

KW - Anti-Inflammatory Agents/therapeutic use

KW - Bacteria/classification

KW - Cohort Studies

KW - Community-Acquired Infections/drug therapy

KW - Dexamethasone/therapeutic use

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Meningitis, Bacterial/drug therapy

KW - Middle Aged

KW - Netherlands/epidemiology

KW - Odds Ratio

KW - Serogroup

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

U2 - https://doi.org/10.1016/S1473-3099(15)00430-2

DO - https://doi.org/10.1016/S1473-3099(15)00430-2

M3 - Article

C2 - 26652862

SN - 1473-3099

VL - 16

SP - 339

EP - 347

JO - Lancet infectious diseases

JF - Lancet infectious diseases

IS - 3

ER -

Bijlsma MW, Brouwer MC, Kasanmoentalib ES, Kloek AT, Lucas MJ, Tanck MW et al. Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study: a prospective cohort study. Lancet infectious diseases. 2016 Mar;16(3):339-347. doi: https://doi.org/10.1016/S1473-3099(15)00430-2