DGI:ZNS-Infektionen/Ambulant erworbene Meningitis/Erreger: Difference between revisions

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==Erreger==
In Abhängigkeit von Patient:innenalter und Immunstatus dominieren unterschiedliche ursächliche Erreger<ref name="erreger0">Ettekoven CN et al., Update on community-acquired bacterial meningitis: guidance and challanges. Clin Microbiol Infect 2017; 23: 601-606</ref><ref>Van den Beek D et al., Community-acquired bacterial meningitis. Nat Rev 2016; Doi:10.1038/nrdp2016.74</ref>. So müssen für die kalkulierte Antibiotikatherapie der akuten ambulant erworbenen bakteriellen Meningitis im Erwachsenenalter verschiedene Erregerspezies Berücksichtigung finden, wobei ''E. coli'' als relevanter Erreger im Erwachsenenalter eine eher untergeordnete Rolle spielt<ref name="erreger0" />.
<span class="ve-pasteProtect" style="font-size:12.0pt;
line-height:115%;font-family:&quot;Arial&quot;,sans-serif" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nline-height:115%;font-family:\&quot;Arial\&quot;,sans-serif&quot;}">In Abhängigkeit von Patientenalter und Immunstatus dominieren unterschiedliche ursächliche Erreger [56, 57]</span><ref name=":0"><span style="color: #333333">56.</span> <span style="color: #333333"> </span><span style="color: #333333">Ettekoven CN et al., Update on community-acquired bacterial meningitis: guidance and challanges.</span> <span style="color: #333333">Clin Microbiol Infect 2017; 23: 601-606</span></ref><ref><span style="color: #333333">57.</span> <span style="color: #333333"> </span><span style="color: #333333">Van den Beek D et al., Community-acquired bacterial meningitis.</span> <span style="color: #333333">Nat Rev 2016; Doi:10.1038/nrdp2016.74</span></ref><span class="ve-pasteProtect" style="font-size:12.0pt;
line-height:115%;font-family:&quot;Arial&quot;,sans-serif" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nline-height:115%;font-family:\&quot;Arial\&quot;,sans-serif&quot;}">. So müssen für die kalkulierte Antibiotikatherapie der akuten ambulant erworbenen bakteriellen Meningitis im Erwachsenenalter verschiedene Erregerspezies Berücksichtigung finden, wobei E. coli als relevanter Erreger im Erwachsenenalter eine eher untergeordnete Rolle spielt [56]</span><ref name=":0" /><span class="ve-pasteProtect" style="font-size:12.0pt;
line-height:115%;font-family:&quot;Arial&quot;,sans-serif" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nline-height:115%;font-family:\&quot;Arial\&quot;,sans-serif&quot;}">.</span>


 
{| class="wikitable"
<span class="ve-pasteProtect" style="font-size:14.0pt;
|+Tab. 2: Relevante bakterielle Erreger der ambulant erworbenen Meningitis bei Erwachsenen in den westlichen Industrieländern (n. <ref name=":2">Thigpen MC et al., Bacterial Menigitis in the United States, 1998-2007. N Engl. J Med 2011; 364:2016-2025</ref>):
line-height:115%;font-family:&quot;Arial&quot;,sans-serif" data-ve-attributes="{&quot;style&quot;:&quot;font-size:14.0pt;\nline-height:115%;font-family:\&quot;Arial\&quot;,sans-serif&quot;}">Tab. 7: Relevante bakterielle Erreger der ambulant erworbenen Meningitis bei Erwachsenen in den westlichen Industrieländern (n. [45</span><ref><span style="color: #333333">45.</span> <span style="color: #333333">   </span> <span style="color: #333333">Thigpen MC et al., Bacterial Menigitis in the United States, 1998-2007.</span> <span style="color: #333333">N Engl. J Med 2011; 364:2016-2025</span></ref><span class="ve-pasteProtect" style="font-size:14.0pt;
!Spezies
line-height:115%;font-family:&quot;Arial&quot;,sans-serif" data-ve-attributes="{&quot;style&quot;:&quot;font-size:14.0pt;\nline-height:115%;font-family:\&quot;Arial\&quot;,sans-serif&quot;}">]):</span>
!Relative Häufigkeit (%)
{| class="wikitable sortable bs-exportable MsoNormalTable" style="width:453.1pt;" border="1" cellspacing="0" cellpadding="0" width="604" data-ve-attributes="{&quot;style&quot;:&quot;width:453.1pt;&quot;}"
!Letalität (%)
|+
|-
! class="col-grey-light-bg" style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">'''Spezies'''</span>
|''Streptokokkus pneumoniae''
! class="col-grey-light-bg" style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |'''<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Inzidenz</span><span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">(%)</span>'''
|57,0
! style="width:117.25pt;" class="col-grey-light-bg" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:117.25pt;&quot;}" |'''<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Letalität</span><span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">(%)</span>'''
|17,9
|- style="height:28.75ptpx;" data-ve-attributes="{&quot;style&quot;:&quot;height:28.75ptpx;&quot;}"
|-
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">Streptokokkus pneumoniae</span>
|''N. meningitidis''
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">57,0</span>
|17,3
| style="width:117.25pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:117.25pt;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">17,9</span>
|10,1
|- style="height:28.75ptpx;" data-ve-attributes="{&quot;style&quot;:&quot;height:28.75ptpx;&quot;}"
|-
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">N. meningitidis</span>
|B-Streptokokken
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">17,3</span>
|16,5
| style="width:117.25pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:117.25pt;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">10,1</span>
|11,1
|- style="height:28.75ptpx;" data-ve-attributes="{&quot;style&quot;:&quot;height:28.75ptpx;&quot;}"
|-
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">B-Streptokokken</span>
|''H. influenzae''
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">16,5</span>
|5,9
| style="width:117.25pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:117.25pt;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">11,1</span>
|7,0
|- style="height:28.75ptpx;" data-ve-attributes="{&quot;style&quot;:&quot;height:28.75ptpx;&quot;}"
|-
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">H. influenzae</span>
|''L. monozytogenes''
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">5,9</span>
|3,3
| style="width:117.25pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:117.25pt;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">7,0</span>
|18,1
|- style="height:28.75ptpx;" data-ve-attributes="{&quot;style&quot;:&quot;height:28.75ptpx;&quot;}"
|}
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">L. monozytogenes</span>
| style="" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">3,3</span>
| style="width:117.25pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:117.25pt;&quot;}" |<span class="ve-pasteProtect" style="color: #0033CC" data-ve-attributes="{&quot;style&quot;:&quot;color: #0033CC&quot;}">18,1</span>
|}<br />

Latest revision as of 13:30, 14 September 2021

In Abhängigkeit von Patient:innenalter und Immunstatus dominieren unterschiedliche ursächliche Erreger[1][2]. So müssen für die kalkulierte Antibiotikatherapie der akuten ambulant erworbenen bakteriellen Meningitis im Erwachsenenalter verschiedene Erregerspezies Berücksichtigung finden, wobei E. coli als relevanter Erreger im Erwachsenenalter eine eher untergeordnete Rolle spielt[1].

Tab. 2: Relevante bakterielle Erreger der ambulant erworbenen Meningitis bei Erwachsenen in den westlichen Industrieländern (n. [3]):
Spezies Relative Häufigkeit (%) Letalität (%)
Streptokokkus pneumoniae 57,0 17,9
N. meningitidis 17,3 10,1
B-Streptokokken 16,5 11,1
H. influenzae 5,9 7,0
L. monozytogenes 3,3 18,1
  1. ↑ 1.0 1.1 Ettekoven CN et al., Update on community-acquired bacterial meningitis: guidance and challanges. Clin Microbiol Infect 2017; 23: 601-606
  2. ↑ Van den Beek D et al., Community-acquired bacterial meningitis. Nat Rev 2016; Doi:10.1038/nrdp2016.74
  3. ↑ Thigpen MC et al., Bacterial Menigitis in the United States, 1998-2007. N Engl. J Med 2011; 364:2016-2025
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