A 15-year retrospective analysis of prognostic factors in childhood bacterial meningitis
| Autor: | Natalie Woon Hui Tan, Matthias Maiwald, Chew Thye Choong, Raymond Reinaldo Tanugroho, Koh Cheng Thoon, Nancy Wen Sim Tee, Subramania Krishnamoorthy, Chia Yin Chong, Liang Yi Justin Wee |
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| Rok vydání: | 2015 |
| Předmět: |
Male
0301 basic medicine Pediatrics medicine.medical_specialty Adolescent Critical Care 030106 microbiology Severity of Illness Index Meningitis Bacterial law.invention 03 medical and health sciences 0302 clinical medicine Blood serum law Outcome Assessment Health Care Severity of illness medicine Humans 030212 general & internal medicine Child Gram-Positive Bacterial Infections Retrospective Studies Singapore Septic shock business.industry Mortality rate Infant Newborn Infant Retrospective cohort study General Medicine Odds ratio Prognosis medicine.disease Intensive care unit Logistic Models Child Preschool Pediatrics Perinatology and Child Health Female Gram-Negative Bacterial Infections business Meningitis Follow-Up Studies |
| Zdroj: | Acta Paediatrica. 105:e22-e29 |
| ISSN: | 0803-5253 |
| DOI: | 10.1111/apa.13228 |
| Popis: | This retrospective chart review aimed to identify factors in childhood bacterial meningitis that predicted disease severity and long-term outcome.The study included 112 episodes of microbiologically confirmed bacterial meningitis in children aged three days to 15 years who were admitted to a Singapore hospital from 1998 to 2013.The mortality rate was 6%, and 44% required intensive care unit (ICU) admission. Predictive factors associated with ICU admission included pneumococcal meningitis, with an odds ratio (OR) of 5.2 and 95% confidence interval (CI) of 1.5-18.2, leukopenia (OR 5.6, 95% CI 1.7-17.9) and a cerebrospinal fluid (CSF):serum glucose ratio0.25 (OR 4.5, 95% CI 1.4-14.4). An initial CSF white blood cell count1000/mm(3) (OR 0.26, 95% CI 0.086-0.76) was negatively associated with ICU admission. Five years after meningitis, 32% had residual sequelae, and the associated prognostic factors were Haemophilus influenzae type b (Hib) meningitis (OR 29.5, 95% CI 2-429), seizures during their inpatient stay (OR 10.6, 95% CI 1.9-60.2) and septic shock (OR 8.4, 95% CI 1.1-62.1).As mortality was low in this bacterial meningitis study, ICU admission was used as a marker of disease severity. These findings underscore the importance of the pneumococcal and Hib meningitis vaccines. |
| Databáze: | OpenAIRE |
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