1180. Healthcare-Associated Meningitis or Ventriculitis in Older Adults
Session: Poster Abstract Session: Clinical Infectious Diseases: CNS Infection
Friday, October 28, 2016
Room: Poster Hall
Background:

Healthcare-associated meningitis or ventriculitis (HCAMV) is a serious and life-threatening complication of invasive neurosurgical procedures or penetrating head trauma. Older adults are at higher risk for adverse outcome in community-acquired meningitis but there are currently no studies evaluating HCAMV.

Methods:

Retrospective study of adults with a diagnosis of HCAMV as defined by the 2015 Center of Disease Control and Prevention (CDC) case definition at a large tertiary care hospital in Houston, Texas from July 2003 to November 2014. Patients were classified as older adults if age ≥ 65 years, or younger adults if age 18-64 years. We collected data on demographics, clinical presentations, laboratory results, imaging studies, treatments and outcomes.

Results:

A total of 160 adult patients were included in the study; 18 patients (11.3%) were older adults. A positive cerebrospinal fluid (CSF) culture was observed in 79 patients (48%). Staphylococcus and Gram-negative rods were the two most common organisms isolated similar to the previous studies. Older adults were found to have higher rates of comorbidities, abnormal neurological exam, and CSF abnormalities [higher CSF protein level and lower CSF glucose level] (P<0.05).

An adverse clinical outcome was seen in 142 patients (88.8%); which was defined as death in 18 patients (12.7%), persistent vegetative state in 26 patients (18.3%), severe disability in 68 patients (47.9%), and moderate disability in 30 patients (21.1%). There was no difference in outcomes between older adults (97%) and younger adults (86.4%), P= 0.075. On logistic regression analysis, abnormal neurological exam (Adjusted OR, 7.13; 95% CI, 2.15, 23.63; P = 0.001), and mechanical ventilation (Adjusted OR, 11.03; 95% CI 1.35, 90.51; P = 0.025) were associated with an adverse clinical outcome.

Conclusion:

Healthcare-associated meningitis or ventriculitis is associated with significant morbidity and mortality in both older and younger adults.

Chanunya Srihawan, MD, Onaizah Habib, MD, Lucrecia Salazar, MD and Rodrigo Hasbun, MD, MPH, Division of Infectious Diseases, University of Texas Health Science Center at Houston, Houston, TX

Disclosures:

C. Srihawan, None

O. Habib, None

L. Salazar, None

R. Hasbun, None

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