Publication details

Profiles of primary brain abscesses and their impact on survival: An international ID-IRI study

Authors	SAHIN Meyha MERT Ali EMECEN Ahmet Naci STRUNJAS Natalija Planinc FAŠANEKOVÁ Lenka BATIREL Ayse DARAZAM Ilad Alavi ANSARI Shabboo FIROUZJAEI Ghazaleh Golchoub STEBEL Roman TIGEN Elif Tukenmez SENGEL Buket Erturk DŽUPOVÁ Olga BELITOVA Maya ABID Maha DEMIRBAS Nazife Duygu EROL Serpil KUL Halil PEKOK Abdullah Umut ULUSOY Tuelay Uenver ALAY Handan AMIRI Zahra Mohtasham CASCIO Antonio KARADAG Mehmet Kuersat KOLOVANI Entela MLADENOV Nikolay RAMOSACO Ergys SIPAHI Oguz Resat SANLIDAG Gamze EL-KHOLY Amani OKAY Gulay PSHENICHNAYA Natalia SAHINOGLU Mustafa Serhat ALKAN Sevil OEZDEMIR Mehmet RAHIMI Bilal Ahmad KARLIDAG Gulden Eser BALIN Safak Oezer LISKOVA Anna JOUHAR Anas ALMAJID Fahad ARTUR Xhumari CELIK Mehmet KHAN Asfandiyar LANZAFAME Massimiliano MARINO Andrea SENOL Arzu ONCU Serkan UGUZ Mustafa ZAJKOWSKA Joanna ERDEM Hakan
Year of publication	2024
Type	Article in Periodical
Magazine / Source	International Journal of Infectious Diseases
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://doi.org/10.1016/j.ijid.2024.107228 https://www.ijidonline.com/article/S1201-9712(24)00299-6/fulltext
Doi	http://dx.doi.org/10.1016/j.ijid.2024.107228
Keywords	Intravenous drug addiction; Microbiological findings; Mortality; Primary brain abscesses; Temporal lobe involvement
Description	Objectives: This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. Methods: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. Results: The patients had a mean +/- SD age of 46.8 +/- 16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with Viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI: 1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). Conclusion: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )