Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Microbiol Immunol Infect. 2009 Oct;42(5):427-32.
Neisseria meningitidis usually causes severe infection in children, but occurs only sporadically in Taiwan. However, the number of infections increased in 2001 and 2002. This study was performed to ascertain the epidemiology and clinical manifestations of infections caused by meningococcus in a pediatric population.
The medical charts of patients with meningococcal diseases who were admitted to Chang Gung Children's Hospital, Taoyuan, Taiwan, from July 1998 to December 2005 were retrospectively reviewed. Data were analyzed for age distribution, serogroups, clinical diagnoses, treatment, acute complications, and outcomes.
Sixteen children with meningococcal disease were identified. Their ages ranged from 1 month to 15 years (average, 3 years). Most patients (62.5%) were younger than 1 year and the second most frequent age group was 6 to 15 years (18.75%). There were 56.25% boys and 43.75% girls. The identified serogroups were B (43.75%), W135 (31.25%), A (6.25%), Y (6.25%), and undetermined (12.5%). The antibiotics used in this study were ampicillin, ceftriaxone, cefotaxime, and aqueous penicillin; the mean total treatment duration was 10 days. Purpura fulminans (37.5%), disseminated intravascular coagulopathy (31.25%), respiratory failure (25.0%), and shock (25.0%) were the commonest acute complications. Most (87.5%) of the patients survived. One patient had long-term sequelae of hearing impairment and speech delay. The mortality rate was 12.5%.
Serogroup B and W-135 were 2 predominant serogroups to cause pediatric meningococcus, and the majority of infections occurred in children younger than 1 year. Continuous surveillance and prevention of meningococcal infections are of great importance.
脑膜炎奈瑟菌通常会导致儿童发生严重感染，但在台湾却很少见。然而，在 2001 年和 2002 年，感染的数量有所增加。本研究旨在确定引起儿童脑膜炎奈瑟菌感染的流行病学和临床表现。
回顾性分析 1998 年 7 月至 2005 年 12 月期间，在台湾桃园长庚儿童医院住院的脑膜炎奈瑟菌感染患儿的病历。分析了年龄分布、血清型、临床诊断、治疗、急性并发症和结局。
共确诊 16 例脑膜炎奈瑟菌感染患儿。年龄为 1 个月至 15 岁（平均 3 岁）。大多数（62.5%）患儿年龄小于 1 岁，其次为 6 至 15 岁（18.75%）。患儿中男童占 56.25%，女童占 43.75%。鉴定出的血清型为 B（43.75%）、W135（31.25%）、A（6.25%）、Y（6.25%）和未确定型（12.5%）。本研究中使用的抗生素为氨苄西林、头孢曲松、头孢噻肟和水剂青霉素；平均总治疗疗程为 10 天。暴发性紫癜（37.5%）、弥漫性血管内凝血（31.25%）、呼吸衰竭（25.0%）和休克（25.0%）是最常见的急性并发症。大多数（87.5%）患儿存活。1 例患儿遗留听力障碍和语言发育迟缓的长期后遗症。死亡率为 12.5%。
血清型 B 和 W-135 是引起儿童脑膜炎奈瑟菌感染的 2 个主要血清型，大多数感染发生在 1 岁以下的儿童中。持续监测和预防脑膜炎奈瑟菌感染非常重要。
