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Epidemiology of adult staphylococcal meningitis in southern Taiwan: a clinical comparison of Staphylococcus aureus infection and coagulase-negative staphylococcal infection.

The clinical and laboratory characteristics of 38 staphylococcal adult bacterial meningitis (ABM) cases (19 Staphylococcus aureus infections and 19 coagulase-negative staphylococcal [CoNS] infections), collected over a period of 6.5 years (July 1999-December 2005; total ABM cases=181) were analyzed. The results were compared with those of our previous study (January 1986-June 1999; total ABM cases=202: monomicrobial infection=180, mixed infection=22, staphylococcal infection=27). The 38 staphylococcal meningitis cases were 21 men and 17 women. Fever and altered consciousness were the leading clinical manifestations. A preceding postneurosurgical state was noted in 12 of the 19 S. aureus infections and all 19 CoNS infections. The ages of onset and mortality rates of S. aureus infection and CoNS infection were 58.21+/-13.05 years and 36.8% (7/19), and 44.16+/-17.57 and 5.3% (1/19), respectively. Eleven of the 19 implicated S. aureus strains and 18 of the 19 implicated CoNS strains were mecA gene-positive and methicillin-resistant; all the strains retained their susceptibility to linezolid. The therapeutic results showed a mortality rate of 21% (8/38). This study revealed an increase of methicillin-resistant, postneurosurgical staphylococcal infection in ABM. Patients with CoNS infection had a younger age at onset and a lower mortality rate.