{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:50:31Z","timestamp":1788267031933,"version":"build-2803163510"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T00:00:00Z","timestamp":1479168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T00:00:00Z","timestamp":1479168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Diabetes mellitus is associated with increased infection rates. We studied clinical features and outcome of community-acquired bacterial meningitis in diabetes patients. Patients were selected from a nationwide, prospective cohort on community-acquired bacterial meningitis performed from March 2006 to October 2014. Data on patient history, symptoms and signs on admission, treatment, and outcome were prospectively collected. A total of 183 of 1447 episodes (13%) occurred in diabetes patients. The incidence of bacterial meningitis in diabetes patients was 3.15 per 100,000 patients per year and the risk of acquiring bacterial meningitis was 2.2-fold higher for diabetes patients.\n                    <jats:italic>S. pneumoniae<\/jats:italic>\n                    was the causative organism in 139 of 183 episodes (76%) and\n                    <jats:italic>L. monocytogenes<\/jats:italic>\n                    in 11 of 183 episodes (6%). Outcome was unfavourable in 82 of 183 episodes (45%) and in 43 of 183 episodes (23%) the patient died. Diabetes was associated with death with an odds ratio of 1.63 (95% CI 1.12\u20132.37, P\u2009=\u20090.011), which remained after adjusting for known predictors of death in a multivariable analysis (OR 1.98 [95% CI 1.13\u20133.48], P\u2009=\u20090.017). In conclusion, diabetes is associated with a 2-fold higher risk of acquiring bacterial meningitis. Diabetes is a strong independent risk factor for death in community-acquired adult bacterial meningitis.\n                  <\/jats:p>","DOI":"10.1038\/srep36996","type":"journal-article","created":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T06:33:35Z","timestamp":1479191615000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Bacterial meningitis in diabetes patients: a population-based prospective study"],"prefix":"10.1038","volume":"6","author":[{"given":"Kiril E. B.","family":"van Veen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs C.","family":"Brouwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie","family":"van der Ende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik","family":"van de Beek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,11,15]]},"reference":[{"key":"BFsrep36996_CR1","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1086\/431587","volume":"41","author":"LM Muller","year":"2005","unstructured":"Muller, L. M. et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis 41, 281\u2013288 (2005).","journal-title":"Clin Infect Dis"},{"key":"BFsrep36996_CR2","doi-asserted-by":"publisher","first-page":"510","DOI":"10.2337\/diacare.26.2.510","volume":"26","author":"BR Shah","year":"2003","unstructured":"Shah, B. R. & Hux, J. E. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 26, 510\u2013513 (2003).","journal-title":"Diabetes Care"},{"key":"BFsrep36996_CR3","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/S0891-5520(05)70153-7","volume":"15","author":"HM Calvet","year":"2001","unstructured":"Calvet, H. M. & Yoshikawa, T. T. Infections in diabetes. Infect Dis Clin North Am 15, 407\u2013421, viii (2001).","journal-title":"Infect Dis Clin North Am"},{"key":"BFsrep36996_CR4","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1007\/s15010-002-3010-4","volume":"30","author":"CR Huang","year":"2002","unstructured":"Huang, C. R. et al. Community-acquired spontaneous bacterial meningitis in adult diabetic patients: an analysis of clinical characteristics and prognostic factors. Infection 30, 346\u2013350 (2002).","journal-title":"Infection"},{"key":"BFsrep36996_CR5","first-page":"28","volume":"28","author":"JM Muli","year":"2007","unstructured":"Muli, J. M. et al. Meningitis in diabetic patients. Neuro Endocrinol Lett 28 Suppl 3, 28\u201329 (2007).","journal-title":"Neuro Endocrinol Lett"},{"key":"BFsrep36996_CR6","first-page":"901","volume":"117","author":"CG Petrovici","year":"2013","unstructured":"Petrovici, C. G. et al. Bacterial meningitis during sepsis in diabetic patient. Rev Med Chir Soc Med Nat Iasi 117, 901\u2013907 (2013).","journal-title":"Rev Med Chir Soc Med Nat Iasi"},{"key":"BFsrep36996_CR7","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/1471-2334-9-57","volume":"9","author":"ES Schut","year":"2009","unstructured":"Schut, E. S. et al. Hyperglycemia in bacterial meningitis: a prospective cohort study. BMC Infect Dis 9, 57 (2009).","journal-title":"BMC Infect Dis"},{"key":"BFsrep36996_CR8","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.diagmicrobio.2015.02.006","volume":"82","author":"J Jung","year":"2015","unstructured":"Jung, J. et al. Comparison of the clinical characteristics and outcomes of Klebsiella pneumoniae and Streptococcus pneumoniae meningitis. Diagn Microbiol Infect Dis 82, 87\u201391 (2015).","journal-title":"Diagn Microbiol Infect Dis"},{"key":"BFsrep36996_CR9","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1186\/1471-2318-11-91","volume":"11","author":"WA Lai","year":"2011","unstructured":"Lai, W. A. et al. Clinical characteristics and prognosis of acute bacterial meningitis in elderly patients over 65: a hospital-based study. BMC Geriatr 11, 91 (2011).","journal-title":"BMC Geriatr"},{"key":"BFsrep36996_CR10","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s15010-006-4144-6","volume":"34","author":"MH Tsai","year":"2006","unstructured":"Tsai, M. H. et al. Bacterial meningitis in young adults in Southern Taiwan: clinical characteristics and therapeutic outcomes. Infection 34, 2\u20138 (2006).","journal-title":"Infection"},{"key":"BFsrep36996_CR11","unstructured":"Bijlsma, M. W. et al. Community-acquired bacterial meningitis in adults in the Netherlands, 2006\u201314: a prospective cohort study. Lancet Infect Dis (2015)."},{"key":"BFsrep36996_CR12","doi-asserted-by":"publisher","first-page":"2700","DOI":"10.1001\/jama.1989.03430190084036","volume":"262","author":"A Spanos","year":"1989","unstructured":"Spanos, A., Harrell, F. E. Jr. & Durack, D. T. Differential diagnosis of acute meningitis. An analysis of the predictive value of initial observations. JAMA 262, 2700\u20132707 (1989).","journal-title":"JAMA"},{"key":"BFsrep36996_CR13","doi-asserted-by":"crossref","unstructured":"American Diabetes, A. Diagnosis and classification of diabetes mellitus. Diabetes Care 31 Suppl 1, S55\u2013S60 (2008).","DOI":"10.2337\/dc08-S055"},{"key":"BFsrep36996_CR14","doi-asserted-by":"crossref","unstructured":"Workgroup on Hypoglycemia, A. D. A. Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care 28, 1245\u20131249 (2005).","DOI":"10.2337\/diacare.28.5.1245"},{"key":"BFsrep36996_CR15","unstructured":"Baan, C. A., Poos, M. J. J. C., Uiters, E. & Savelkoul, M. Hoe vaak komt diabetes mellitus voor en hoeveel mensen sterven eraan? Volksgezondheid Toekomst Verkenning, Nationaal Kompas Volksgezondheid (National Public Health Compass). RIVM. Bilthoven. (2014)."},{"key":"BFsrep36996_CR16","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1056\/NEJMoa040845","volume":"351","author":"D van de Beek","year":"2004","unstructured":"van de Beek, D. et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351, 1849\u20131859 (2004).","journal-title":"N Engl J Med"},{"key":"BFsrep36996_CR17","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1093\/cid\/cit250","volume":"57","author":"MM Koopmans","year":"2013","unstructured":"Koopmans, M. M. et al. Listeria monocytogenes sequence type 6 and increased rate of unfavorable outcome in meningitis: epidemiologic cohort study. Clin Infect Dis 57, 247\u2013253 (2013).","journal-title":"Clin Infect Dis"},{"key":"BFsrep36996_CR18","doi-asserted-by":"crossref","unstructured":"van de Beek, D. et al. ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clin Microbiol Infect (2016).","DOI":"10.1016\/j.cmi.2016.01.007"},{"key":"BFsrep36996_CR19","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1111\/j.1464-5491.1994.tb00250.x","volume":"11","author":"P Pozzilli","year":"1994","unstructured":"Pozzilli, P. & Leslie, R. D. Infections and diabetes: mechanisms and prospects for prevention. Diabet Med 11, 935\u2013941 (1994).","journal-title":"Diabet Med"},{"key":"BFsrep36996_CR20","doi-asserted-by":"publisher","first-page":"553","DOI":"10.2337\/diacare.27.2.553","volume":"27","author":"S Clement","year":"2004","unstructured":"Clement, S. et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care 27, 553\u2013591 (2004).","journal-title":"Diabetes Care"},{"key":"BFsrep36996_CR21","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1128\/CMR.00070-09","volume":"23","author":"MC Brouwer","year":"2010","unstructured":"Brouwer, M. C., Tunkel, A. R. & van de Beek, D. Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. Clin Microbiol Rev 23, 467\u2013492 (2010).","journal-title":"Clin Microbiol Rev"},{"key":"BFsrep36996_CR22","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1111\/j.1468-1331.2008.02193.x","volume":"15","author":"A Chaudhuri","year":"2008","unstructured":"Chaudhuri, A. et al. EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur J Neurol 15, 649\u2013659 (2008).","journal-title":"Eur J Neurol"},{"key":"BFsrep36996_CR23","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1086\/425368","volume":"39","author":"AR Tunkel","year":"2004","unstructured":"Tunkel, A. R. et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39, 1267\u20131284 (2004).","journal-title":"Clin Infect Dis"},{"key":"BFsrep36996_CR24","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1056\/NEJMoa021334","volume":"347","author":"J de Gans","year":"2002","unstructured":"de Gans, J., van de Beek, D. & European Dexamethasone in Adulthood Bacterial Meningitis Study, I. Dexamethasone in adults with bacterial meningitis. N Engl J Med 347, 1549\u20131556 (2002).","journal-title":"N Engl J Med"},{"key":"BFsrep36996_CR25","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1016\/S0140-6736(12)61186-6","volume":"380","author":"D van de Beek","year":"2012","unstructured":"van de Beek, D., Brouwer, M. C., Thwaites, G. E. & Tunkel, A. R. Advances in treatment of bacterial meningitis. Lancet 380, 1693\u20131702 (2012).","journal-title":"Lancet"},{"key":"BFsrep36996_CR26","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/S1473-3099(04)00937-5","volume":"4","author":"D van de Beek","year":"2004","unstructured":"van de Beek, D., de Gans, J., McIntyre, P. & Prasad, K. Steroids in adults with acute bacterial meningitis: a systematic review. Lancet Infect Dis 4, 139\u2013143 (2004).","journal-title":"Lancet Infect Dis"},{"key":"BFsrep36996_CR27","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/S1474-4422(10)70023-5","volume":"9","author":"D van de Beek","year":"2010","unstructured":"van de Beek, D. et al. Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data. Lancet Neurol 9, 254\u2013263 (2010).","journal-title":"Lancet Neurol"},{"key":"BFsrep36996_CR28","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1056\/NEJMra052116","volume":"354","author":"D van de Beek","year":"2006","unstructured":"van de Beek, D., de Gans, J., Tunkel, A. R. & Wijdicks, E. F. Community-acquired bacterial meningitis in adults. N Engl J Med 354, 44\u201353 (2006).","journal-title":"N Engl J Med"},{"key":"BFsrep36996_CR29","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/S1473-3099(15)00430-2","volume":"16","author":"MW Bijlsma","year":"2016","unstructured":"Bijlsma, M. W. et al. Community-acquired bacterial meningitis in adults in the Netherlands, 2006\u201314: a prospective cohort study. Lancet Infect Dis 16, 339\u2013347 (2016).","journal-title":"Lancet Infect Dis"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep36996.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep36996","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep36996.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T21:59:33Z","timestamp":1672869573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep36996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,15]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,12,23]]}},"alternative-id":["BFsrep36996"],"URL":"https:\/\/doi.org\/10.1038\/srep36996","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,15]]},"assertion":[{"value":"24 June 2016","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2016","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 November 2016","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"36996"}}