A 15-year retrospective analysis of prognostic factors in childhood bacterial meningitis.
Acta Paediatr
; 105(1): e22-9, 2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-26426265
ABSTRACT
AIM:
This retrospective chart review aimed to identify factors in childhood bacterial meningitis that predicted disease severity and long-term outcome.METHODS:
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.RESULTS:
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 ratio <0.25 (OR 4.5, 95% CI 1.4-14.4). An initial CSF white blood cell count >1000/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).CONCLUSION:
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
3_ND
/
4_TD
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Base de dados:
MEDLINE
Assunto principal:
Meningites Bacterianas
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Infecções por Bactérias Gram-Positivas
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Infecções por Bactérias Gram-Negativas
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
/
Newborn
País/Região como assunto:
Asia
Idioma:
En
Revista:
Acta Paediatr
Ano de publicação:
2016
Tipo de documento:
Article