Introduction: Acute meningitis is a serious illness in the Intensive Care Unit (ICU) with a high mortality rate and long length of stay (LOS). There are few epidemiological and outcomes reports in Latin America of this pathology in the ICU. Methods: Design. Retrospective study. Setting: ICU at tertiary-level hospital in México, n=28. Inclusion. Age 16-72 years, with clinical suspicion of acute meningitis who had a lumbar puncture with positive Cerebrospinal fluid CSF culture or positive multiplex PCR from January 2021 to December 2024. Variables: a) Acute meningitis, b) Demographic and clinical characteristics, c) laboratory investigations of CSF causative organisms d) antimicrobial sensitivity results, e) ICU LOS, f) hospital LOS and g) outcomes. Statistics: Frequencies, percentages, mean. Results: In the study period were admitted 2,027 patients in the ICU, 46 (2%) had clinical suspicion of acute meningitis, from these only twenty-eight (1.3%) had a positive CSF culture or positive CSF PCR and were included for the analysis considering both community-acquired infection (CAI) or healthcare-associated infection (HAI). We obtained 31 isolates, 20 (64%) Gram positive bacteria (GPB), 10 (32%) Gram negative bacteria (GNB) and 1 (3%) fungus. Eighteen (64%) were classified as CA infection and 10 (36%) as HAI. The predominant GPB were Coagulase-negative Staphylococci 13 (65%), from these 9 (69.2%) had a history of surgery, head trauma or CSF drainage device. The predominant GNB were Acinetobacter baumannii 3 (30%), and Escherichia coli 3 (30%). Four isolates (57%) from GNB were extensively drug-resistant (XDR). The mean LOS was 7 days in ICU and 27 days in hospital. ICU mortality was 18%, while hospital mortality reached 42%. Hospital mortality was higher in the GPB group (50%) compared to the GNB group (29%). Conclusions: Our report of acute meningitis showed a lower incidence and higher mortality than those reported in other Latin American centers, as well as a prolonged hospital stay. The GPB group predominates, although higher resistance was found in the GNB group. The high mortality rate, especially in the GPB group, underscores the seriousness of this disease.
Mijangos et al. (Sun,) studied this question.