Zainel Abdulwahed, Mitchell Hana, Sadarangani Manish
Department of Pediatrics, Division of Infectious Diseases, University of British Columbia, Vancouver, BC V6t 1Z4, Canada.
Vaccine Evaluation Center, BC Children's Hospital, Vancouver, BC V6H 3N1, Canada.
Microorganisms. 2021 Mar 5;9(3):535. doi: 10.3390/microorganisms9030535.
Bacterial meningitis is a devastating infection, with a case fatality rate of up to 30% and 50% of survivors developing neurological complications. These include short-term complications such as focal neurological deficit and subdural effusion, and long-term complications such as hearing loss, seizures, cognitive impairment and hydrocephalus. Complications develop due to bacterial toxin release and the host immune response, which lead to neuronal damage. Factors associated with increased risk of developing neurological complications include young age, delayed presentation and as an etiologic agent. Vaccination is the primary method of preventing bacterial meningitis and therefore its complications. There are three vaccine preventable causes: type b (Hib), and Starting antibiotics without delay is also critical to reduce the risk of neurological complications. Additionally, early adjuvant corticosteroid use in Hib meningitis reduces the risk of hearing loss and severe neurological complications.
细菌性脑膜炎是一种极具破坏性的感染性疾病，病死率高达30%，且50%的幸存者会出现神经系统并发症。这些并发症包括短期并发症，如局灶性神经功能缺损和硬膜下积液，以及长期并发症，如听力丧失、癫痫发作、认知障碍和脑积水。并发症的发生是由于细菌毒素释放和宿主免疫反应，进而导致神经元损伤。与发生神经系统并发症风险增加相关的因素包括年龄小、就诊延迟以及作为病原体。接种疫苗是预防细菌性脑膜炎及其并发症的主要方法。有三种可通过疫苗预防的病因：b型流感嗜血杆菌（Hib）、肺炎链球菌和脑膜炎奈瑟菌。及时使用抗生素对于降低神经系统并发症的风险也至关重要。此外，在Hib脑膜炎中早期使用辅助性皮质类固醇可降低听力丧失和严重神经系统并发症的风险。
