{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:19:38Z","timestamp":1782386378259,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:00:00Z","timestamp":1648512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003180","name":"Academisch Medisch Centrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003180","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007192","name":"Rijksinstituut voor Volksgezondheid en Milieu","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007192","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["917.17.308"],"award-info":[{"award-number":["917.17.308"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["918.19.627"],"award-info":[{"award-number":["918.19.627"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2022,7]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Advanced age is a risk factor for unfavorable outcome in community\u2010acquired bacterial meningitis, but clinical characteristics and outcome in meningitis patients of 80\u2009years or older have not been defined.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We compared clinical characteristics and outcome of community\u2010acquired bacterial meningitis patients aged 80\u2009years or older and adults under 80\u2009years old within a prospective nationwide cohort study.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Out of 2140 episodes identified between March 2006 and July 2018, 149 occurred in patients aged 80\u2009years or older (7%). Common predisposing factors other than age were diabetes mellitus (25 of 148 [17%]), otitis or sinusitis (30 of 136 [22%]), and pneumonia (23 of 141 [16%]). The triad of fever, neck stiffness and altered consciousness was present in 60 of 139 (43%). The most common causative pathogen was\n Streptococcus pneumoniae<\/jats:italic>\n (99 of 149 [66%]). Atypical causative pathogens, such as\n Listeria monocytogenes<\/jats:italic>\n ,\n Staphylococcus aureus<\/jats:italic>\n , and\n Escherichia coli<\/jats:italic>\n , occurred more often compared to younger patients (49 of 149 [33%] vs 362 of 1991 [18%];\n p<\/jats:italic>\n \u2009<\u20090.001). Patients of 80\u2009years and older had high case fatality rate (75 of 149 [50%]), but 45 of 149 (30%) had a favorable outcome. Characteristics associated with an unfavorable outcome were absence of otitis or sinusitis, presence of aphasia, mono\u2010 or hemiparesis, a lower score on the Glasgow Coma Scale, a higher heart rate, a higher blood C\u2010reactive protein concentration and CSF leukocytes <100 per mm\n 3<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Bacterial meningitis in patients of 80\u2009years of older is associated with high rates of unfavorable outcome and death. Atypical causative pathogens such as\n L. monocytogenes<\/jats:italic>\n ,\n S. aureus<\/jats:italic>\n , and\n E. coli<\/jats:italic>\n occur commonly and should be considered when starting empirical antimicrobial therapy in this age group.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.17766","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T02:30:06Z","timestamp":1648607406000},"page":"2060-2069","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Community\u2010acquired bacterial meningitis in patients of 80\u2009years and older"],"prefix":"10.1111","volume":"70","author":[{"given":"Thijs M.","family":"van Soest","sequence":"first","affiliation":[{"name":"Department of Neurology, Amsterdam Neuroscience Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Chekrouni","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam Neuroscience Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina M.","family":"van Sorge","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands"},{"name":"Netherlands Reference Laboratory for Bacterial Meningitis Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs C.","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam Neuroscience Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik","family":"van de Beek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam Neuroscience Amsterdam UMC, University of Amsterdam Amsterdam The 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