Community-Acquired Bacterial Meningitis in Tuzla Canton (2014-2024): An 11-Year Retrospective Analysis of Clinical Features, Pathogens, and Prognostic Factors.

BACKGROUND

Community-acquired bacterial meningitis (CABM) remains a life-threatening infection with high morbidity and mortality, despite advances in antibiotic therapy and vaccination. Understanding local epidemiology is crucial for improving outcomes.

OBJECTIVE

To evaluate clinical and epidemiological characteristics and outcome of patients with bacterial meningitis in all age groups.

METHODS

This retrospective study analyzed 78 cases of CABM treated at the University Clinical Center Tuzla from 2014 to 2024. Patients were divided by age and outcome. Clinical features, laboratory results, microbiological findings, and prognostic factors were examined.

RESULTS

Adults comprised 59% of cases, and children 41%, with a median age of 29 years. The most common symptoms were fever (91%), positive meningeal signs (76.9%), vomiting (69.2%), and headache (66.7%). Streptococcus pneumoniae (24.4%) and Neisseria meningitidis (14.1%) were the leading pathogens. Mortality was 14.1%, significantly higher in adults (19.6%) than in children (6.3%). Poor outcomes were associated with older age, coma, ICU admission, and complications such as cerebral abscess or shock. Laboratory indicators of worse prognosis included thrombocytopenia, elevated urea and creatinine, hypokalemia, and low CSF cell count.

CONCLUSION

CABM remains a serious clinical problem in Tuzla Canton. Early recognition, appropriate empiric antibiotic treatment, ICU management, and preventive measures such as vaccination are essential for improving survival, particularly in high-risk populations.