Gupta Sarika, Srivastava Akanksha D
Department of Paediatrics, King George Medical University, Lucknow, Uttar Pradesh, India.
Department of Paediatrics, Carrier Institute of Medical Science and Hospital, Lucknow, Uttar Pradesh, India.
J Glob Infect Dis. 2025 Mar 31;17(1):29-35. doi: 10.4103/jgid.jgid_161_24. eCollection 2025 Jan-Mar.
The study aimed to evaluate the risk factors linked to poor outcomes in pediatric patients diagnosed with tubercular bacterial meningitis (TBM).
A retrospective cohort study was conducted at King George's Medical University in India, focusing on children diagnosed with TBM ( = 514) over a 5-year period from 2019 to 2023. The study evaluates various aspects of TBM in this population, including clinical presentation, diagnostic methods, and outcomes. Statistical analyses for the study were conducted using SPSS version 16.0 (SPSS, Chicago, IL, USA).
Out of a total of 514 patients with TBM, 98 (19.1%) patients experienced a poor outcome. Multivariate analysis identified several factors associated with a poor outcome: age over 5 years ( = 0.829, = 0.002, odds ratio [OR] = 2.291, 95% confidence interval [CI]: 1.344-3.904), altered consciousness ( = 1.040, < 0.001, OR = 2.829, 95% CI: 1.686-4.747), a cerebrospinal fluid (CSF)-to-plasma glucose ratio <50% ( = -0.892, = 0.001, OR = 0.410, 95% CI: 0.244-0.688), hydrocephalus ( = 1.050, = 0.003, OR = 2.857, 95% CI: 1.417-5.760), and lack of Bacille Calmette-Guerin (BCG) immunization ( = 1.291, < 0.001, OR = 3.638, 95% CI: 2.150-6.156).
The study identified key risk factors for poor outcomes in childhood TBM, including age over 5 years, high CSF protein levels, coma, hydrocephalus, and inadequate BCG immunization. These factors underline the severity of childhood TBM as a public health issue and emphasize the need for timely initiation of antituberculosis therapy.
本研究旨在评估诊断为结核性细菌性脑膜炎（TBM）的儿科患者预后不良的相关危险因素。
在印度乔治国王医科大学进行了一项回顾性队列研究，重点关注2019年至2023年这5年间诊断为TBM的儿童（n = 514）。该研究评估了该人群中TBM的各个方面，包括临床表现、诊断方法和预后。研究的统计分析使用SPSS 16.0版本（SPSS，美国伊利诺伊州芝加哥）进行。
在总共514例TBM患者中，98例（19.1%）患者预后不良。多因素分析确定了几个与预后不良相关的因素：5岁以上（β = 0.829，P = 0.002，比值比[OR] = 2.291，95%置信区间[CI]：1.344 - 3.904）、意识改变（β = 1.040，P < 0.001，OR = 2.829，95% CI：1.686 - 4.747）、脑脊液（CSF）与血浆葡萄糖比值<50%（β = -0.892，P = 0.001，OR = 0.410，95% CI：0.244 - 0.688）、脑积水（β = 1.050，P = 0.003，OR = 2.857，95% CI：1.417 - 5.760）以及未接种卡介苗（BCG）（β = 1.291，P < 0.001，OR = 3.638，95% CI：2.150 - 6.156）。
该研究确定了儿童TBM预后不良的关键危险因素，包括5岁以上、脑脊液蛋白水平高、昏迷、脑积水和卡介苗接种不足。这些因素突显了儿童TBM作为一个公共卫生问题的严重性，并强调了及时开始抗结核治疗的必要性。
