A Retrospectively Analysis Of Clinical And CSF Features Of Purulent Meningitis

Objective To retrospective1 y analyze the bacterial records for cerebrospinal fluid(CSF) of adult purulent meningitis(APM)a, and explore its characteristics.Methods In total, 201 patients of definite APM in our hospital in the past 13 years were studied.We made a retrospective analysis of the bacterial records for CSF in 144 patients with bacterial culture. The pathogenic bacterial constitution and drug sensitivity tests were analyzed;The clinical and CSF features were compared between CSF culture negative(CN) and positive groups(CP) and among gram-positive bacillus(G+bacillus),gram-negative bacillus(G—bacillus), and gram-positive coccus(G+coccus).Results The bacterial detection rate of the APM was 36.8%. The mainly causative bacterium was gram-positive coccus(64.15%), of this, the main pathogenic bacteria was Staphylococcus. Most Staphylococcus were resistant to penicillin. The age, occurrences of male, with disturbance of consciousness and seizures in CP group were higher than CN group(P<0.05); And the blood neutrophils ratio, CSF WBC counts and CSF protein level in CP group were higher than CN group(P<0.05). In the patients arrived hospital within ten days, the CSF pressure, CSF WBC counts, CSF neutrophils ratio in CP group were higher than CN group,and the CSF lymphocyte ratio was lower than CN group(P<0.05). The gram-positive bacillus group had the higher occurrence rate of seizureattacks and hydrencephalus or brain edema than the gram-negative bacillus group and gram-positive coccus group(P<0.05).Conclusions The mainly causative bacterium in APM are listeria monocytogenes, staphylococcus aureus, staphylococcus epidermidis,streptococcus pneumoniae and staphylococcus intermedius. We found that the male and older patients who were accompanied with seizure, shiver and conscious disturbance were more likely to obtain positive CSF culture results. CSF culture positive patients had the higher inflammation markers level than culture negative patients. The gram-positive bacilli were more likely to cause seizure attack and hydrencephalus or brain edema. These findings may be useful to guide the clinical practice.