Profiles of primary brain abscesses and their impact on survival: An international ID-IRI study
Language English Country Canada Media print-electronic
Document type Journal Article, Multicenter Study
PubMed
39216784
DOI
10.1016/j.ijid.2024.107228
PII: S1201-9712(24)00299-6
Knihovny.cz E-resources
- Keywords
- Intravenous drug addiction, Microbiological findings, Mortality, Primary brain abscesses, Temporal lobe involvement,
- MeSH
- Brain Abscess * microbiology mortality MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Survival Rate MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Names of Substances
- Anti-Bacterial Agents MeSH
OBJECTIVES: This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. METHODS: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. RESULTS: The patients had a mean ± SD age of 46.8 ± 16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with Viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI: 1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). CONCLUSION: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.
Bacha Khan Medical Complex Swabi Pakistan
Department of Infectious Diseases and Clinical Microbiology Adnan Menderes University Aydin Türkiye
Department of Infectious Diseases and Clinical Microbiology Manisa City Hospital Manisa Türkiye
Department of Infectious Diseases and Clinical Microbiology Mersin City Hospital Mersin Türkiye
Department of Infectious Diseases Central Research Institute of Epidemiology Moscow Russia
Department of Infectious Diseases University Medical Center Ljubljana Ljubljana Slovenia
Department of Medicine King Saud University Riyadh Saudi Arabia
Department of Microbiology Necmettin Erbakan University Meram Medical School Hospital Konya Türkiye
Department of Neurology Damascus Hospital Damascus Syria
Department of Neurosurgery Ankara City Hospital Ankara Türkiye
Dokuz Eylul University Research and Application Hospital Izmir Türkiye
Faculty of Medicine Department of Clinical Pathology Cairo University Cairo Egypt
Faculty of Medicine Department of Neurosurgery Ataturk University Erzurum Türkiye
Guilan Road Trauma Research Center Guilan University of Medical Sciences Rasht Iran
Hospital Nitra St Elisabeth University of Health Care and Social Work Bratislava Slovak Republic
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