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亚马逊地区儿童中枢神经系统感染:临床与实验室特征。

Pediatric central nervous system infections in the Amazon: clinical and laboratory profiles.

机构信息

Universidade Federal do Amazonas, Manaus, Brazil.

Universidade do Estado do Amazonas, Manaus, Brazil.

出版信息

Front Public Health. 2023 Dec 21;11:1329091. doi: 10.3389/fpubh.2023.1329091. eCollection 2023.

Abstract

BACKGROUND

Central nervous system (CNS) infections are important causes of mortality and morbidity in children, and they are related to severe problems such as hearing loss, neurological sequelae, and death. The objective was to describe clinical and laboratory exam profiles of children who were diagnosed with CNS infections.

METHODS

We conducted a cross-sectional study based on medical records, which included pediatric patients aged from 3 months to 15 years, with a clinical suspicion of CNS infection between January 2014 to December 2019. The pathogens were confirmed in cerebrospinal fluid (CSF) samples using Gram staining, cell culture, molecular diagnostics (PCR and qPCR), and serology.

RESULTS

Out of the 689 enrolled patients, 108 (15.6%) had laboratory-confirmed infections in CSF. The most common bacterial pathogens isolated from the culture were serogroup C in 19, in 11, and in seven samples. The viruses identified were , , Var, , and arbovirus. No patient was found to be positive for . Patients with viral infections showed altered levels of consciousness ( = 0.001) when compared to bacterial infections.

CONCLUSION

This study shows the presence of important vaccine-preventable pathogens, and different families of viruses causing CNS infections in the pediatric patients of Manaus.

摘要

背景

中枢神经系统(CNS)感染是儿童死亡和发病的重要原因,可导致听力损失、神经后遗症和死亡等严重问题。本研究旨在描述中枢神经系统感染患儿的临床和实验室检查特征。

方法

我们开展了一项基于病历的横断面研究,纳入了 2014 年 1 月至 2019 年 12 月期间疑似患有中枢神经系统感染的 3 个月至 15 岁儿科患者。通过革兰氏染色、细胞培养、分子诊断(PCR 和 qPCR)和血清学方法在脑脊液(CSF)样本中确定病原体。

结果

在纳入的 689 例患者中,有 108 例(15.6%)的 CSF 实验室检查结果为感染。从培养物中分离出的最常见细菌病原体为 19 例血清群 C、11 例 、7 例 。鉴定出的病毒包括 、 、Var 、 、和虫媒病毒。未发现患者 呈阳性。与细菌感染相比,病毒感染患者的意识水平改变(=0.001)。

结论

本研究表明,在马瑙斯的儿科患者中存在重要的疫苗可预防病原体和不同的病毒家族引起的中枢神经系统感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a941/10768178/4db487b9db52/fpubh-11-1329091-g001.jpg

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