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A 15-year retrospective analysis of prognostic factors in childhood bacterial meningitis.
Wee, Liang Yi Justin; Tanugroho, Raymond Reinaldo; Thoon, Koh Cheng; Chong, Chia Yin; Choong, Chew Thye; Krishnamoorthy, Subramania; Maiwald, Matthias; Tee, Nancy Wen Sim; Tan, Natalie Woon Hui.
Afiliación
  • Wee LY; Department of Paediatrics, KK Women's and Children's Hospital, Singapore City, Singapore.
  • Tanugroho RR; Department of Paediatrics, KK Women's and Children's Hospital, Singapore City, Singapore.
  • Thoon KC; Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore City, Singapore.
  • Chong CY; Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
  • Choong CT; Duke-National University of Singapore Graduate Medical School, Singapore City, Singapore.
  • Krishnamoorthy S; Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore City, Singapore.
  • Maiwald M; Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
  • Tee NW; Duke-National University of Singapore Graduate Medical School, Singapore City, Singapore.
  • Tan NW; Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
Acta Paediatr ; 105(1): e22-9, 2016 Jan.
Article en En | MEDLINE | ID: mdl-26426265
AIM: This retrospective chart review aimed to identify factors in childhood bacterial meningitis that predicted disease severity and long-term outcome. METHODS: The study included 112 episodes of microbiologically confirmed bacterial meningitis in children aged three days to 15 years who were admitted to a Singapore hospital from 1998 to 2013. RESULTS: The mortality rate was 6%, and 44% required intensive care unit (ICU) admission. Predictive factors associated with ICU admission included pneumococcal meningitis, with an odds ratio (OR) of 5.2 and 95% confidence interval (CI) of 1.5-18.2, leukopenia (OR 5.6, 95% CI 1.7-17.9) and a cerebrospinal fluid (CSF):serum glucose ratio <0.25 (OR 4.5, 95% CI 1.4-14.4). An initial CSF white blood cell count >1000/mm(3) (OR 0.26, 95% CI 0.086-0.76) was negatively associated with ICU admission. Five years after meningitis, 32% had residual sequelae, and the associated prognostic factors were Haemophilus influenzae type b (Hib) meningitis (OR 29.5, 95% CI 2-429), seizures during their inpatient stay (OR 10.6, 95% CI 1.9-60.2) and septic shock (OR 8.4, 95% CI 1.1-62.1). CONCLUSION: As mortality was low in this bacterial meningitis study, ICU admission was used as a marker of disease severity. These findings underscore the importance of the pneumococcal and Hib meningitis vaccines.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Meningitis Bacterianas / Infecciones por Bacterias Grampositivas / Infecciones por Bacterias Gramnegativas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: Asia Idioma: En Revista: Acta Paediatr Año: 2016 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Noruega
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Meningitis Bacterianas / Infecciones por Bacterias Grampositivas / Infecciones por Bacterias Gramnegativas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: Asia Idioma: En Revista: Acta Paediatr Año: 2016 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Noruega