|
Characteristics
|
No. of cases
|
No. deaths (%)
|
Univariate Hazard Ratio (95% CI)
|
Adjusted Hazard Ratio (95% CI) a
|
|---|
|
Age category
| | | | |
|
<1 years
|
189
|
109 (58)
|
2.58 (1.90-3.50)
|
2.61 (1.54-4.43)
|
|
1-4 years
|
55
|
27 (49)
|
2.20 (1.49-3.24)
|
3.14 (1.57-6.29)
|
|
5-14 years
|
98
|
10 (10)
|
0.46 (0.24-0.88)
|
0.67 (0.28-1.56)
|
|
15-50 years
|
170
|
38 (23)
|
1.0
|
1.0
|
|
>50 years
|
33
|
18 (55)
|
2.44 (1.61-3.71)
|
2.14 (1.11-4.10)
|
|
Female
|
193
|
81 (42)
|
1.21 (0.97-1.51)
| |
|
Underlying conditionb
|
141
|
42 (30)
|
0.75 (0.57-1.00)
| |
|
Clinical presentation
| | | | |
|
Seizures prior to hospitalization
|
181
|
83 (46)
|
1.40 (1.13-1.74)
| |
|
Coma on admission
|
83
|
47 (57)
|
1.69 (1.34-2.12)
|
2.55 (1.66-3.91)
|
|
Laboratory values
| | | | |
|
Blood leukocyte count < 15,000 cells/μL
|
200
|
89 (44)
|
1.36 (1.09-1.69)
|
3.53 (2.18-5.71)
|
|
CSF protein >300 mg/dLc
|
308
|
125 (41)
|
1.36 (1.07-1.73)
|
1.88 (1.12-3.17)
|
|
Pneumococcal isolate resistant to penicillind
|
93
|
45 (48)
|
1.39 (1.09-1.78)
|
1.62 (1.08-2.43)
|
|
Serotype 14
|
74
|
36 (49)
|
1.38 (1.06-1.80)
|
0.52 (0.29-0.91)
|
|
Treatment
| | | | |
|
Discordant therapy e
|
22
|
10 (45)
|
1.24 (0.77-1.98)
| |
|
Systemic corticosteroids f
|
412/539
|
159 (39)
|
1.25 (0.94-1.68)
| |
|
ICU admission
|
235/548
|
130 (55)
|
2.37 (1.88-2.99)
| |
-
NOTE: CI, confidence interval; MIC, minimal inhibitory concentration; ICU, intensive care unit.
-
a Hazard ratios and 95% confidence intervals from multivariable Cox proportional hazards model including age category, presence of coma, CSF protein >300 mg/dL, blood leukocyte count <15,000 cells/μL, penicillin MIC >0.06 μg/ml and serotype 14.
-
b Includes HIV infection, diabetes mellitus, asplenia, sickle cell disease, congestive heart failure, other disorders associated with immunodepression and recurrent meningitis.
-
c CSF protein measured at time of admission; data missing for 12 case patients.
-
d Defined as penicillin MIC >0.06 μg/ml for a pneumococcal isolate from a patient with meningitis.
-
e Antibiotic therapy was defined as discordant when patients did not receive any antibiotic to which the S. pneumoniae isolate was susceptible during the initial 24 hours of hospitalization.
-
f Defined as initiation of corticosteroid therapy within 48 hours of admission; information missing for 9 case patients.
