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Bacterial load may predict morbidity, mortality in patients with meningococcal disease
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Bacterial load was associated with mortality risk, development of permanent disease sequelae and extended hospitalization in patients with meningococcal disease.
Patients with Neisseria meningitidis serogroup C were more likely to have a high bacterial load than those with infections from other serogroups. Age and interleukin-1 genotype were associated with mortality but those associations were independent of a high genomic bacterial load level.
Researchers reviewed data from 1,045 patients presenting with meningococcal disease at hospitals in England and Wales from January 1999 through December 2001. They assessed N. meningitidis DNA levels using polymerase chain reaction detection.
Bacterial load levels were not associated with patient age, delay in sample submission or administration of antibiotics before admission, according to the researchers.
The median log bacterial load was 5.29 log10 copies/mL (interquartile range, 4.41 log10 copies/mL to 6.30 log10 copies/mL) in the 95 patients who died. In the 950 patients who survived, it was 3.79 log10 copies/mL (interquartile range, 2.87 log10 copies/mL to 4.71 log10 copies/mL).
Analysis demonstrated that age (OR=1.04 per one-year increase in age) and bacterial load (OR=2.04 per log10 copies/mL increase) had a statistically significant effect on mortality risk. Patients who were in the hospital more than 10 days; patients who had digit, limb or soft-tissue loss; and patients who required hemodialysis were more likely to have a higher bacterial load.
Clin Infect Dis. 2009;48:587-594.