Epidemiology and clinical characteristics of Klebsiella spp. meningitis in France - INRAE - Institut national de recherche pour l’agriculture, l’alimentation et l’environnement Access content directly
Journal Articles Infectious Diseases Now Year : 2022

Epidemiology and clinical characteristics of Klebsiella spp. meningitis in France

Eric Farfour
Anne-Gaëlle Ranc
Vincent Fihman
Nicolas Degand
Frédéric Laurent
Cécile Le Brun
Olivier Barraud
Jean-Ralph Zahar

Abstract

Objectives: To describe the epidemiology of Klebsiella spp. meningitis in France with respect to clinical and bacteriological data. Methods: We performed a four-year multicenter, retrospective, observational study. The primary objective was to provide a clinical description of patients with Klebsiella spp. meningitis. Secondary objectives were to compare community-acquired meningitis and healthcare-associated meningitis and to analyze factors associated with mortality. Results: We enrolled 131 patients with Klebsiella spp. meningitis. Eighty-two (62.6%) infections were reported following neurosurgery. Twenty-eight strains (21.4%) were resistant to third-generation cephalosporins (3GC). The median [IQR] cellularity was 980/mm3 [116-5550], the median protein level was 5.67 [1.62-9] g/L and the median CSF glucose level was 2.5 [0-3.4] mmol/L. The in-hospital mortality rate was 23.6%. Community-acquired meningitis isolates were more frequently susceptible to 3GC than isolates from healthcare-associated meningitis (89.2% versus 72%; P=0.04). Comorbidities reported for patients with community-acquired meningitis were mainly diabetes mellitus and liver cirrhosis. In multivariate analysis, focal neurological disorder at the time of diagnosis was the only factor associated with in-hospital mortality (P=0.01). Conclusions: Purulent meningitis caused by Klebsiella spp. needs to be considered in patients with community-acquired meningitis and preexisting conditions, as well as in case of meningitis following neurosurgical procedures.

Dates and versions

hal-04144819 , version 1 (28-06-2023)

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Benoît Pilmis, Gauthier Péan de Ponfilly, Eric Farfour, Anne-Gaëlle Ranc, Vincent Fihman, et al.. Epidemiology and clinical characteristics of Klebsiella spp. meningitis in France. Infectious Diseases Now, 2022, 52 (2), pp.82-86. ⟨10.1016/j.idnow.2021.05.006⟩. ⟨hal-04144819⟩
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