Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.
37664Faculty of Medicine, University of Ljubljana, Slovenia.
J Child Neurol. 2022 Jan;37(1):64-72. doi: 10.1177/08830738211053128. Epub 2021 Nov 24.
To find early predictors for poor neurodevelopmental outcome after neonatal group B streptococcal meningitis.
We retrospectively analyzed clinical characteristics of 23 patients with neonatal group B streptococcal meningitis and their neurodevelopmental outcome at 18 months. Available group B strains were serotyped and their genomes characterized.
We found several differences between patients with early- (n = 5) and late-onset (n = 18) disease. Nine children had neurologic abnormalities at 18 months and 4 had epilepsy, all of them after late-onset disease. Most important risk factors for poor outcome were impaired consciousness at admission, hemodynamic instability, seizures, or abnormal electroencephalogram during the acute illness and abnormal neurologic and ophthalmologic examination at the end of treatment, whereas abnormalities in laboratory and imaging studies were not predictive. Hypervirulent serotype III, multilocus sequence type 17 group B was the predominant pathogen.
Neurodevelopmental impairment after neonatal group B streptococcal meningitis is likelier in those with clinical and neurophysiological features indicating worse disease severity.
寻找新生儿 B 组链球菌脑膜炎后神经发育不良结局的早期预测指标。
我们回顾性分析了 23 例新生儿 B 组链球菌脑膜炎患者的临床特征及其 18 个月时的神经发育结局。对可用的 B 群菌株进行血清分型，并对其基因组进行特征分析。
我们发现早发型（n=5）和晚发型（n=18）疾病患者之间存在一些差异。9 名儿童在 18 个月时有神经功能异常，其中 4 名患有癫痫，均发生在晚发型疾病之后。预后不良的最重要危险因素是入院时意识障碍、血流动力学不稳定、癫痫发作或急性疾病期间脑电图异常以及治疗结束时神经和眼科检查异常，而实验室和影像学检查异常无预测价值。高毒力血清型 III、多位点序列型 17 组 B 是主要病原体。
具有更严重疾病严重程度临床和神经生理学特征的新生儿 B 组链球菌脑膜炎后神经发育障碍更有可能发生。
