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

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==Erreger==
==Erreger==
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In Abhängigkeit von Patientenalter und Immunstatus dominieren unterschiedliche ursächliche Erreger<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>. 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=":0" />.
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"
|+Tab. 7: Relevante bakterielle Erreger der ambulant erworbenen Meningitis bei Erwachsenen in den westlichen Industrieländern (n. <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>):
!Spezies
!Inzidenz (%)
!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
|}


<span class="ve-pasteProtect" style="font-size:14.0pt;
 
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;
 
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>
<br />
{| 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;}"
<references />
|+
! 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>
! 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>'''
! 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>'''
|- 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>
| 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>
| 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>
|- 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>
| 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>
| 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>
|- 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>
| 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>
| 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>
|- 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>
| 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>
| 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>
|- 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 />

Revision as of 14:40, 17 June 2021

Erreger

In Abhängigkeit von Patientenalter 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. 7: Relevante bakterielle Erreger der ambulant erworbenen Meningitis bei Erwachsenen in den westlichen Industrieländern (n. [3]):
Spezies Inzidenz (%) 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 56.  Ettekoven CN et al., Update on community-acquired bacterial meningitis: guidance and challanges. Clin Microbiol Infect 2017; 23: 601-606
  2. ↑ 57.  Van den Beek D et al., Community-acquired bacterial meningitis. Nat Rev 2016; Doi:10.1038/nrdp2016.74
  3. ↑ 45.     Thigpen MC et al., Bacterial Menigitis in the United States, 1998-2007. N Engl. J Med 2011; 364:2016-2025
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