Salaun-Saraux P, Saraux A, Lepage P, Van Goethem C, Hitimana D G, Bazubagira A, Cénac A, Bogaerts J
Service de Pédiatrie, Centre Hospitalier de Kigali, Rwanda.
Med Trop (Mars). 1995;55(1):41-5.
To assess septic meningitis in pediatric units in terms of the bacteriologic distribution, mortality, and groups at risk, we conducted a retrospective study in the pediatric department of the Kigali Hospital Center (Rwanda). Based on bacteriologic study of 1215 cerebrospinal fluid samples, there were 321 cases of septic meningitis due to identifiable germs and 68 involving cloudy fluid with no detectable germs, i.e. 1.5% of admissions to the Pediatric Unit of the Kigali Hospital Center. The most common organisms were pneumococcus (36.5%), Haemophilus influenzae (31%), salmonella (13%), and meningococcus (11.5%). Most of the children (75%) presenting septic meningitis were under the age of 5 years. Overall mortality was 38% with rates of 52% and 39% for cases involving pneumococcus and salmonella respectively. The predominant clinical symptoms of pneumococcus meningitis were coma (p:0.000055) and respiratory compromise (p:0.02). In contrast Haemophilus influenzae meningitis was associated with a lower incidence of coma (p:0.05) and malnutrition (p:0.017). Salmonella meningitis was characterized by a higher incidence of fever over 38.9 degrees C (p:0.025) and malnutrition (p:0.01). In patients with meningococcus meningitis, the incidence of convulsions appeared to be higher, at the threshold of statistical significance (p:0.052), whereas coma (p:0062) and respiratory distress (p:0.0024) were uncommon. Independently of etiology, no clinical symptom was associated with a statistically higher risk for death.
为了从细菌学分布、死亡率和风险群体方面评估卢旺达基加利医院中心儿科病房的化脓性脑膜炎情况，我们在该医院中心的儿科进行了一项回顾性研究。基于对1215份脑脊液样本的细菌学研究，有321例因可识别病原菌导致的化脓性脑膜炎病例，68例脑脊液浑浊但未检测到病原菌，即占基加利医院中心儿科病房入院人数的1.5%。最常见的病原菌是肺炎球菌（36.5%）、流感嗜血杆菌（31%）、沙门氏菌（13%）和脑膜炎球菌（11.5%）。大多数患化脓性脑膜炎的儿童（75%）年龄在5岁以下。总体死亡率为38%，肺炎球菌和沙门氏菌感染病例的死亡率分别为52%和39%。肺炎球菌脑膜炎的主要临床症状是昏迷（p:0.000055）和呼吸功能不全（p:0.02）。相比之下，流感嗜血杆菌脑膜炎昏迷（p:0.05）和营养不良（p:0.017）的发生率较低。沙门氏菌脑膜炎的特征是体温超过38.9摄氏度（p:0.025）和营养不良（p:0.01）的发生率较高。在脑膜炎球菌脑膜炎患者中，惊厥发生率似乎较高，接近统计学显著性阈值（p:0.052），而昏迷（p:0.0062）和呼吸窘迫（p:0.0024）并不常见。无论病因如何，没有临床症状与统计学上更高的死亡风险相关。
