Department of Otorhinolaryngology, Turku University Hospital, University of Turku, Turku, Finland.
Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
Acta Paediatr. 2024 Feb;113(2):327-335. doi: 10.1111/apa.16991. Epub 2023 Oct 6.
This study examined the predisposing factors, clinical picture, bacterial aetiology and clinical outcomes of infants and children with bacterial meningitis (BM).
The medical records of patients under 16 years of age, treated by Turku University Hospital, Finland, from 2011 to 2018, were screened for meningitis using the International Classification of Diseases, Tenth Revision codes. Patients were included if bacteria were detected in cerebrospinal fluid (CSF) or other predefined laboratory variables indicated BM, despite CSF testing negative for bacteria. The Glasgow Outcome Scale (GOS) was used to determine outcomes.
We identified 37 children with BM: 22 infants aged 0-89 days and 15 children aged 90 days to 15 years. The overall incidence was approximately 5.7/100 000/year. Nosocomial meningitis was documented in 51%. Bacterial growth was detected in the CSF or blood cultures of the majority of patients (57%). Escherichia coli (14%), group B streptococcus (11%) and Streptococcus pneumoniae (8%) were the most common pathogens. There were 14% of patients with unfavourable outcomes, namely GOS scores of 1-4, but no deaths.
The incidence of paediatric BM was low during the study period, but the proportion of nosocomial meningitis was substantial. The frequency of unfavourable long-term outcomes was relatively low.
本研究旨在探讨婴儿和儿童细菌性脑膜炎(BM)的易患因素、临床表现、细菌病因学和临床结局。
本研究对芬兰图尔库大学医院 2011 年至 2018 年收治的年龄在 16 岁以下的患者的病历进行了筛选,使用国际疾病分类第十版(ICD-10)编码来筛查脑膜炎。如果脑脊液(CSF)中检测到细菌,或其他预设的实验室变量表明存在 BM,即使 CSF 细菌检测为阴性,也将患者纳入研究。采用格拉斯哥结局量表(GOS)来判断结局。
本研究共纳入 37 例 BM 患儿:22 例为 0-89 日龄的婴儿,15 例为 90 日龄至 15 岁的儿童。总体发病率约为 5.7/100000/年。有 51%的患儿为医院获得性脑膜炎。大多数患者的 CSF 或血液培养中均检测到细菌生长(57%)。大肠埃希菌(14%)、B 组链球菌(11%)和肺炎链球菌(8%)是最常见的病原体。14%的患儿预后不良,即 GOS 评分为 1-4,但无死亡病例。
在研究期间,儿科 BM 的发病率较低,但医院获得性脑膜炎的比例相当高。不良长期结局的发生率相对较低。