Clinical Neurology and Neurosurgery 107 (2005) 366–370 Bacterial meningitis in Hong Kong: 10-years’ experience A.C.F. Hui a,∗ , K.C. Ng b , P.Y. Tong a , V. Mok a , K.M. Chow a , A. Wu a , L.K.S. Wong a a Department of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, New Terriotories, Shatin, Hong Kong SAR b Department of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR Received 1 July 2004; received in revised form 29 September 2004; accepted 4 October 2004 Abstract Objective: We studied the etiology, clinical features and outcome of patients with bacterial meningitis from an urban Chinese city over a 10-years period. Methods: We reviewed the files of all persons aged 15-years old or above diagnosed with community-acquired bacterial meningitis from a regional hospital. The clinical findings, relevant laboratory and imaging results as well as outcome were recorded in cases with microbiological evidence of meningitis. Neurosurgical and pediatric patients were excluded. Results: Sixty-five patients between the ages of 15 and 86 years of age (mean 52 years) were identified of whom 18 (28%) died. The four most common causes were Mycobacteria tuberculosis (46%), Streptococcus pneumoniae (11%), Streptococcus suis (9%) and Klebsiella pneumoniae (8%). Neisseria meningitidis and Haemophilus influenzae were rare pathogens. The annual incidence of community-acquired bacterial meningitis was 1.27/100,000 adults. Delay in treatment was associated with a poorer prognosis (p < 0.001, OR = 38.84, CI = 7.33–205.80). Conclusion: The causative organisms found in this region of China differ from that reported from Europe and the US; tuberculous meningitis is the most common cause of bacterial meningitis. © 2004 Elsevier B.V. All rights reserved. Keywords: Bacterial meningitis; Tuberculous meningitis; Cerebrospinal fluid; Prognosis; Epidemiology 1. Bacterial meningitis in Hong Kong: 10-years experience Bacterial meningitis remains a neurological emergency with a high mortality rate despite advances in diagnostic tech- niques and chemotherapy [1–3]. Optimal treatment depends on prompt treatment with the most appropriate antibiotic but there is limited data on the range of potential causative organ- isms in patients with meningitis in South China [4–6]. This article reviews the incidence, etiology, clinical features and CSF findings, as well as predictors of poor outcome among adult patients with community-acquired bacterial meningitis from Hong Kong, China. ∗ Corresponding author. Tel.: +852 2632 3131/3133; fax: +852 2637 5396. E-mail address: cfhui@cuhk.edu.hk (A.C.F. Hui). 2. Methods We identified all cases of adult community-acquired bacterial meningitis over a 10-year period from 1992 to 2001 at the Prince of Wales Hospital, Hong Kong. This is a 1400-bed facility that serves as the main community hospital in a predominantly residential area of Hong Kong. Patients were identified from the department of medicine’s computerized admission/discharge system using Interna- tional Classification of Disease (ICD)-diagnosis codes 320, 320.0, 320.1, 320.2, 320.3, 320.7, 320.8, 320.9. 036.0, 013.0 and from the records of the department of microbiology. The diagnosis of bacterial meningitis was made in patients with a compatible clinical picture and definite identification of an etiological agent (a) positive CSF smear on Gram or Ziehl-Nielson staining, (b) isolation of a specific pathogen from CSF culture and (c) positive histology on biopsy of brain tissue or at autopsy. The following exclusion criteria applied: (a) patients below 15 years of age, (b) patients 0303-8467/$ – see front matter © 2004 Elsevier B.V. All rights reserved. doi:10.1016/j.clineuro.2004.10.006