1174. Epidemiology of Meningitis and Encephalitis in the United States from 2011-2014.
Session: Poster Abstract Session: Clinical Infectious Diseases: CNS Infection
Friday, October 28, 2016
Room: Poster Hall
Posters
  • ME Poster.pdf (534.8 kB)
  • Background:

    Meningitis and encephalitis can be caused by various infectious pathogens but large epidemiological studies evaluating etiologies, management decisions and outcomes in the United States (US) are lacking.

    Methods:

    All adult patients (age ≥18 years) with a discharge or admitting diagnosis of meningitis or encephalitis by ICD-9 codes available in the US Premier Healthcare Database from 2011-2014 were analyzed.

    Results:

    A total of 26,429 patients with meningitis or encephalitis were identified. The median age was 43 years; 53% were female. The most common etiology was viral (16152, 61%); followed by unknown (4944, 18.7%), bacterial (3692, 13.9%), non-infectious (921, 3.4%), and fungal (720, 2.7%). Empirical antibiotics, antivirals and antifungals were administered in 85.8%, 53.4%, and 7.8%, respectively and varied by etiologies. Adjunctive steroids were utilized in 25.1% of all patients and in 44.7% of patients with bacterial meningitis. The median length of hospital stay was 4 days; with the longest duration in those with fungal (13 days), arboviral (10 days ), and bacterial meningitis (7 days) . Overall mortality was 2.9% and was higher in those with bacterial (8.2%), fungal (8.2%), or arboviral (8.9%) etiologies. Readmission rate at 30 days was 3.2%; patients with arbovirus (12.7%), bacterial (6.7%) and fungal (5.4%) etiologies had higher rates.

    Conclusion:

    Meningitis and encephalitis was most commonly caused by viruses; management decisions and clinical outcomes vary by etiology. Adjunctive steroids are being underutilized in bacterial meningitis.

    Rodrigo Hasbun, MD, MPH1, Ning Rosenthal, MD MPH2, Jessica Chung, Phd MPH2, Christine ‎ Ginocchio, PhD MT3, Joan-Miquel Balada-Llasat, Pharm D, PhD4, Lou Banks, Senior Global Brand Manager5, Louise Zimmer, Research Coordinator3 and Samuel Bozzette, MD PhD3, (1)Division of Infectious Diseases, University of Texas Health Science Center at Houston, Houston, TX, (2)Premier Research, Charlotte, NC, (3)bioMérieux, Durham, NC, (4)Ohio State University Medical Center, Columbus, OH, (5)Biofire Diagnostics, Salt Lake City, UT

    Disclosures:

    R. Hasbun, bioMérieux: Consultant , Consulting fee

    N. Rosenthal, Premier access: Consultant , Contracted by Biomeriaux

    J. Chung, Premier access: Consultant , contracted by Biomerieux

    C. Ginocchio, BioFire Diagnostics: Employee , Salary

    J. M. Balada-Llasat, Biomerieux: Consultant , Consulting fee

    L. Banks, Biofire diagnostics: Employee , Salary

    L. Zimmer, Biomerieux: Employee , Salary

    S. Bozzette, Biomerieux: Employee , Salary

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.