Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
Invasive Meningococcal Disease In Adults Aged ≥65 Years Admitted To French Intensive Care Units: A Nationwide Comparison With Younger Adults.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Contou Damien, Painvin Benoit, Daubin Delphine, Orieux Arthur, Pirollet Hugo, Cour Martin, Sarton Benjamin, Gauvrit Marie, Taillantou-Candau Mathilde, Lepoutre Paola, Louis Guillaume, Bruneel Fabrice, Teiten Christelle, Vincendeau Maud, Giry Marion, Legay François, Coudroy Rémi, Puig Olivier, Bay Pierre, Schnell Guillaume, Ledoux Geoffrey, Sonneville Romain, Reuter Danielle, Valette Xavier, Szychowiak Piotr, Dufour Nicolas, Urbina Tomas, Plantefève Gaëtan, de Prost Nicolas
Аннотация
BACKGROUND: Invasive meningococcal disease (IMD) is traditionally associated with younger populations, but its impact on older adults is rising. We aimed to describe the clinical characteristics and outcomes of critically ill older patients with IMD and identify risk factors for in-hospital mortality.
METHODS: We conducted an ancillary analysis of the French nationwide multicenter RETRO-MENINGO cohort (2016-2024). All adults admitted to 102 ICUs with microbiologically confirmed IMD were included and stratified by age (≥65 vs. <65 years). The primary outcome was all-cause in-hospital mortality. Multivariable logistic regression identified factors independently associated with death.
RESULTS: Among 654 patients, 114 (17%) were aged ≥65 years, of whom only 0.9% were reported as vaccinated. Compared to younger adults, older patients presented more frequently with hemodynamic failure and less often with classic purpura or meningeal symptoms. Serogroup W predominated in the older group, while serogroup B was more common in younger patients. Older adults required more organ support and had significantly higher in-hospital mortality (28.1%, n=32/114 vs. 9.6%, n=52/540 p<0.001). After adjustment, age ≥65 years remained independently associated with in-hospital mortality (aOR 2.99; 95% CI 1.57-5.72; p<0.001), while administration of a third-generation cephalosporin before ICU admission was protective (aOR 0.45; 95% CI, 0.24-0.84; p=0.01).
CONCLUSIONS: Critically ill older adults with IMD exhibit atypical clinical features, a high prevalence of serogroup W, and nearly triple the in-hospital mortality of younger patients. These findings emphasize the need for high clinical suspicion, rapid antibiotic therapy, and potential expansion of vaccination strategies to include older populations.
METHODS: We conducted an ancillary analysis of the French nationwide multicenter RETRO-MENINGO cohort (2016-2024). All adults admitted to 102 ICUs with microbiologically confirmed IMD were included and stratified by age (≥65 vs. <65 years). The primary outcome was all-cause in-hospital mortality. Multivariable logistic regression identified factors independently associated with death.
RESULTS: Among 654 patients, 114 (17%) were aged ≥65 years, of whom only 0.9% were reported as vaccinated. Compared to younger adults, older patients presented more frequently with hemodynamic failure and less often with classic purpura or meningeal symptoms. Serogroup W predominated in the older group, while serogroup B was more common in younger patients. Older adults required more organ support and had significantly higher in-hospital mortality (28.1%, n=32/114 vs. 9.6%, n=52/540 p<0.001). After adjustment, age ≥65 years remained independently associated with in-hospital mortality (aOR 2.99; 95% CI 1.57-5.72; p<0.001), while administration of a third-generation cephalosporin before ICU admission was protective (aOR 0.45; 95% CI, 0.24-0.84; p=0.01).
CONCLUSIONS: Critically ill older adults with IMD exhibit atypical clinical features, a high prevalence of serogroup W, and nearly triple the in-hospital mortality of younger patients. These findings emphasize the need for high clinical suspicion, rapid antibiotic therapy, and potential expansion of vaccination strategies to include older populations.