[Community acquired acute bacterial meningitis--a 10 year review].

UNLABELLED: Bacterial meningitis is still an important topic for the infectious diseases specialist, due to it's high incidence, severity and it's high mortality rate.

MATERIAL AND METHOD: We retrospectively studied 679 patients diagnosed with community acquired bacterial meningitis in the Infectious Diseases Hospital Iaşi, Romania between 1998 and 2007.

RESULTS

The annual number of admissions slightly decreased in the last years. Most patients were males (62.1%). Predisposing factors were present in 34.9% of cases. Seizures were described in 19.6% of cases, more frequent in children. The CSF was purulent only in 69.4% of patients, 29.6% of them receiving antibiotics prior to admission; the albumin level in the CSF of pneumococcal meningitis was higher than in other meningitis. The etiology was established in 51.6% of cases, more frequent in sucklings (68.1%). N. meningitidis was the most common cause of community acquired acute bacterial meningitis (CABM) (28.5%) followed by S. pneumoniae (14%). S. pneumoniae was susceptible to penicillin in 79% of cases. The mean mortality rate was 13.1%.

CONCLUSION

Factors associated with a poor prognosis were: pneumococcal etiology, age over 60, and the presence of seizures or coma at admission.