• Saundra Smyrski

Adult Bacterial Meningitis- Costly & Devastating




A vaccine is not a cure-all. This is the reality for the approximately 2,600 patients in the United States that are affected my Bacteria Meningitis, despite the presence of the vaccines against Streptococcus pn adult patientseumonia & Haemophilus influenzae type b. Despite antibiotics given, Meningococcal disease carries a mortality rate of 10-15% and an additional 10% likelihood of neurological deficits thereafter.


In 2006, a nationwide study concluded 15,700 hospitalization this year, with an average of 16.6 days per stay, related to bacterial meningitis. This equated to an average of $33,100 per stay and a total of $520.4 million in aggregated costs (Kiyani, et al., 2021). In similar fashion, a recent study was conducted with a focus on the health economic burden and risk of complications of bacterial meningitis secondary to nosocomial (originating in a hospital) and community acquired infections.


Costs determined included inpatient service costs charged to the hospital, outpatient service costs, outpatient medication costs, and aggregated costs.


Secondary outcomes included 30-day complications and 30-day in hospital mortality. Complications included:

  • hydrocephalus

  • intracranial epidural abscess

  • intracerebral hemorrhage

  • cerebral edema

  • respiratory distress syndrome

  • septic shock and

  • brain herniation.

In this study, a total of 4,496 adult patients were identified. 834 either had traumatic head injuries or neurosurgical complications. Out of the 3,662 patients who did not have head trauma or neurosurgical complications, 3,091 had community-acquired bacterial meningitis and 571 had nosocomial meningitis.


Findings


  1. A higher proportion of patients with preceding traumatic head injuries or neurosurgical complications had nosocomial infections (54.0% vs. 15.6%) (Kiyani, et al., 2021).

  2. The most frequent bacterial type, was Streptococcus (20.1%) in atraumatic patients.

  3. The most frequent bacterial type, was Staphylococcus/ Methicillin-resistant Staphylococcus aureus and Gram-negative bacteria (17.4%) were the most common etiologic agents.

  4. The overall median length of stay (LOS) for the initial bacterial meningitis admission was longer when prior head injuries or neurosurgical complications occurred (17 vs 8 days) or when nosocomial bacteria were the culprit (head trauma complications: 21 vs 13 days; no head trauma).

  5. Patients with streptococcal meningitis had a significantly higher 30-day mortality rate of 7.2% compared with 3.8% for all other bacterial meningitides (Kiyani, et al., 2021).

  6. Community-acquired group had a higher overall complication rate than the nosocomial group (29.6% vs. 26.5%) including higher rates of:

  7. cerebral edema

  8. abducens nerve palsy

  9. intracranial epidural abscess

  10. brain herniation

  11. intracranial hemorrhage

  12. septic shock

  13. respiratory distress syndrome

  14. disseminated intravascular coagulation

  15. Hydrocephalus was the most common complication overall.

  16. The median baseline cost accrued for nosocomial infections and for those with prior traumatic head injuries or interventions were significantly higher compared with community-acquire infections and atraumatic patients (Kiyani, et al., 2021).

Overall, the results from this study, "...indicate a substantial health economic burden, morbid complications, and inpatient mortality associated with both nosocomial and community acquired bacterial meningitis. Although bacterial meningitis is known to be a leading infectious cause of death, there is not nearly enough comprehensive and current research.


What Now?


If your client suffered a life-altering complication following a traumatic hospital stay, or neurosurgery hospitalization, contact us at Saundra Smyrski LLC- 727.225.4358, to rule out the potential of hospital acquired complications.
















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