Prevalence of causative bacteria and clinical outcomes among patients with meningitis at a regional central hospital in Thailand

Main Article Content

Wichai Santimaleeworagun
Nirun Jangkong
Ketmanee Petchhouyluek
Nalinrat Leawsrivilai
Wichayaporn Suwanraksa
Wimonsiri Buapool


This study aimed to identify causative bacteria and to investigate the outcomes of treatment and the appropriate empirical regimen among patients with bacterial meningitis. Patients with bacterial meningitis admitted at Ratchaburi Hospital during January 2012 to December 2016 were included. Of two hundred and eight patients, 76 cases of them with known causative pathogens were included. Fifty-five cases were males (72.4%) and 55.2% of patients were aged 2-50 years. Sixty three out of 76 patients with meningitis (82.9%) were community acquired (CA-) bacterial meningitis. The most frequently found isolated pathogens in 63 CA-bacterial meningitis cases were S. agalactiae followed by S. pneumoniae. While A. baumannii and K. pneumoniae were the top-two isolated organisms among 13 hospital acquired cases. The rates of in-hospital mortality among 76 cases were 18.4%. The third generation cephalosporins plus vancomycin was the most active agent against bacteria (87.3%) isolated from CA-bacterial meningitis whereas carbapenems plus vancomycin remain an effective choice against bacteria (84.6%) isolated from patients with hospital acquired meningitis. However, the most common of causative pathogens were a Gram-positive bacteria in community setting and Gram-negative bacteria in hospital setting. The appropriate empirical regimen against bacteria in both setting have to be further investigated.


Download data is not yet available.

Article Details

Research Articles


Abat, C., Chaudet, H., Raoult, D., and Colson, P. (2014). Increasing trend of invasive group B streptococcal infections, Marseille, France. Clinical Infectious Diseases, 58, 750-751.

Bureau of Epidemiology. (2018). National Disease Surveillance (Report 506). In Thailand National Disease Surveillance Report, Thailand.

Chotmongkol, V., and Techoruangwiwat, C. (2000). Community acquired-bacterial meningitis in adults. The Southeast Asian Journal of Tropical Medicine and Public Health, 31, 506-508.

Chusri, S., Sakarunchai, I., Kositpantawong, N., Panthuwong, S., Santimaleeworagun, W., Pattharachayakul, S., Singkhamanan, K. and Doi, Y. (2018). Outcomes of adjunctive therapy with intrathecal or intraventricular administration of colistin for post-neurosurgical meningitis and ventriculitis due to carbapenem-resistant Acinetobacter baumannii. International Journal of Antimicrobial Agents, 51, 646-650.

Dzupova, O., Rozsypal, H., Prochazka, B., and Benes, J. (2009). Acute bacterial meningitis in adults: predictors of outcome. Scandinavian Journal of Infectious Diseases, 41, 348-354.

GBD 2017 Causes of Death Collaborators. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the global burden of disease study 2017. The Lancet, 392(10159), 1736-1788.

Heckenberg, S. G., Brouwer, M. C., and Beek, D. (2014). Bacterial meningitis. Handbook of Clinical Neurology, 121, 1361-1375.

Khwannimit, B., and Chayakul, P. (2004). Community-acquired bacterial meningitis in adults in Songklanagarind Hospital: a 20-year review. Songklanagarind Medical Journal, 22, 383-391.

Khwannimit, B., Chayakul, P., and Geater, A. (2004). Acute bacterial meningitis in adults: a 20 year review. The Southeast Asian Journal of Tropical Medicine and Public Health, 35, 886-892.

Køster-Rasmussen, R., Korshin, A., and Meyer, C. N. (2008). Antibiotic treatment delay and outcome in acute bacterial meningitis. Journal of Infection, 57, 449-454.

Lu, C. H., Huang, C. R., Chang, W. N., Chang, C. J., Cheng, B. C., Lee, P. Y., Lin, M. W., and Chang, H. W. (2002). Community-acquired bacterial meningitis in adults: the epidemiology, timing of appropriate antimicrobial therapy, and prognostic factors. Clinical Neurology and Neurosurgery, 104, 352-358.

Oordt-Speets, A. M., Bolijn, R., Hoorn, R. C., Bhavsar, A. and Kyaw, M. H. (2018). Global etiology of bacterial meningitis: A systematic review and meta-analysis. PLoS One, 13, e0198772.

Phares, C. R., Lynfield, R., Farley, M. M., Mohle-Boetani, J., Harrison, L. H., Petit, S., Craig, A. S., Schaffner, W., Zansky, S. M., Gershman, K., Stefonek, K. R., Albanese, B. A., Zell, E. R., Schuchat, A., Schrag, S. J., and Active Bacterial Core Surveillance/Emerging Infections Program, N. (2008). Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. The Journal of the American Medical Association, 299(17), 2056-2065.

Sribussara, P., and Rusmeechan, S. (2007). Bacterial meningitis in Buddhachinaraj hospital during 1998-2003. Buddhachinaraj Medical Journal, 24, 275-286.

Suphanklang, J., Santimaleeworagun, W., Thunyaharn, S., and Traipattanakul, J. (2017). Pneumococcal meningitis at a Thai hospital over a 10-year period: clinical outcomes, serotypes, and antimicrobial susceptibility patterns. Southeast Asian Journal of Tropical Medicine and Public Health, 48, 1281-1289.

Tunkel, A. R., Hartman, B. J., Kaplan, S. L., Kaufman, B. A., Roos, K. L., Scheld, W. M., and Whitley, R. J. (2004). Practice guidelines for the management of bacterial meningitis. Clinical Infectious Diseases, 39, 1267-1284.