A prospective study of risk factors for neurological complications in childhood bacterial meningitis
Objective: To prospectively analyze the prognostic factors for neurological complications of childhood bacterial meningitis. Methods: This prospective study enrolled 77 children from 1 month until 16 years of age, treated for bacterial meningitis during the period of January 1, 2009 through December...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | Portuguese |
| Published: |
Brazilian Society of Pediatrics
2013-05-01
|
| Series: | Jornal de Pediatria (Versão em Português) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255553613000517 |
| _version_ | 1828159328960380928 |
|---|---|
| author | Sadie Namani Zvonko Milenković Bulëza Koci |
| author_facet | Sadie Namani Zvonko Milenković Bulëza Koci |
| author_sort | Sadie Namani |
| collection | DOAJ |
| description | Objective: To prospectively analyze the prognostic factors for neurological complications of childhood bacterial meningitis.
Methods: This prospective study enrolled 77 children from 1 month until 16 years of age, treated for bacterial meningitis during the period of January 1, 2009 through December 31, 2010. 16 relevant predictors were chosen to analyze their association with the incidence of neurological complications. p-values < 0.05 were considered statistically significant.
Results: Of the 77 children treated for bacterial meningitis, 33 patients developed neurological complications (43%), and two children died (2.6%). The etiology of bacterial meningitis cases was proven in 57/77 (74%) cases: 32 meningococci, eight pneumococci, six Gram-negative bacilli, five H. influenzae, five staphylococci, and one S. viridans isolates were found. Factors found to be associated with increased risk of development of neurological complications were age < 12 months, altered mental status, seizures prior to admission, initial therapy with two antibiotics, dexamethasone use, presence of focal neurological deficit on admission and increased proteins in cerebrospinal fluid (CSF) (p < 0.05). Initial pleocytosis > 5,000 cells/mm3, pleocytosis > 5,000 cells/mm3 after 48 hours, CSF/blood glucose ratio < 0.20, female gender, previous treatment with antibiotics, community-acquired infection, duration of illness > 48 hours, presence of comorbidity, and primary focus of infection were not associated with increased risk for the development of neurological complications.
Conclusion: Age < 12 months and severity of clinical presentation at admission were identified as the strongest predictors of neurological complications and may be of value in selecting patients for more intensive care and treatment. |
| first_indexed | 2024-04-11T23:59:43Z |
| format | Article |
| id | doaj.art-2a6d9f4cb7b24bf582d723836aa03b3a |
| institution | Directory Open Access Journal |
| issn | 2255-5536 |
| language | Portuguese |
| last_indexed | 2024-04-11T23:59:43Z |
| publishDate | 2013-05-01 |
| publisher | Brazilian Society of Pediatrics |
| record_format | Article |
| series | Jornal de Pediatria (Versão em Português) |
| spelling | doaj.art-2a6d9f4cb7b24bf582d723836aa03b3a2022-12-22T03:56:16ZporBrazilian Society of PediatricsJornal de Pediatria (Versão em Português)2255-55362013-05-0189325626210.1016/j.jpedp.2012.10.009A prospective study of risk factors for neurological complications in childhood bacterial meningitisSadie Namani0Zvonko Milenković1Bulëza Koci2Doutora. Infectious Diseases Clinic, University Clinical Center of Kosovo, Medical Faculty, University of Prishtina, KosovoDoutor. Clinic for Infectious Diseases and Febrile Conditions, Skopje, MacedôniaMestre. Burg-Apotheke, Konigstein am Taunus, AlemanhaObjective: To prospectively analyze the prognostic factors for neurological complications of childhood bacterial meningitis. Methods: This prospective study enrolled 77 children from 1 month until 16 years of age, treated for bacterial meningitis during the period of January 1, 2009 through December 31, 2010. 16 relevant predictors were chosen to analyze their association with the incidence of neurological complications. p-values < 0.05 were considered statistically significant. Results: Of the 77 children treated for bacterial meningitis, 33 patients developed neurological complications (43%), and two children died (2.6%). The etiology of bacterial meningitis cases was proven in 57/77 (74%) cases: 32 meningococci, eight pneumococci, six Gram-negative bacilli, five H. influenzae, five staphylococci, and one S. viridans isolates were found. Factors found to be associated with increased risk of development of neurological complications were age < 12 months, altered mental status, seizures prior to admission, initial therapy with two antibiotics, dexamethasone use, presence of focal neurological deficit on admission and increased proteins in cerebrospinal fluid (CSF) (p < 0.05). Initial pleocytosis > 5,000 cells/mm3, pleocytosis > 5,000 cells/mm3 after 48 hours, CSF/blood glucose ratio < 0.20, female gender, previous treatment with antibiotics, community-acquired infection, duration of illness > 48 hours, presence of comorbidity, and primary focus of infection were not associated with increased risk for the development of neurological complications. Conclusion: Age < 12 months and severity of clinical presentation at admission were identified as the strongest predictors of neurological complications and may be of value in selecting patients for more intensive care and treatment.http://www.sciencedirect.com/science/article/pii/S2255553613000517Bacterial meningitisNeurological complicationsChildrenOutcomes |
| spellingShingle | Sadie Namani Zvonko Milenković Bulëza Koci A prospective study of risk factors for neurological complications in childhood bacterial meningitis Jornal de Pediatria (Versão em Português) Bacterial meningitis Neurological complications Children Outcomes |
| title | A prospective study of risk factors for neurological complications in childhood bacterial meningitis |
| title_full | A prospective study of risk factors for neurological complications in childhood bacterial meningitis |
| title_fullStr | A prospective study of risk factors for neurological complications in childhood bacterial meningitis |
| title_full_unstemmed | A prospective study of risk factors for neurological complications in childhood bacterial meningitis |
| title_short | A prospective study of risk factors for neurological complications in childhood bacterial meningitis |
| title_sort | prospective study of risk factors for neurological complications in childhood bacterial meningitis |
| topic | Bacterial meningitis Neurological complications Children Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2255553613000517 |
| work_keys_str_mv | AT sadienamani aprospectivestudyofriskfactorsforneurologicalcomplicationsinchildhoodbacterialmeningitis AT zvonkomilenkovic aprospectivestudyofriskfactorsforneurologicalcomplicationsinchildhoodbacterialmeningitis AT bulezakoci aprospectivestudyofriskfactorsforneurologicalcomplicationsinchildhoodbacterialmeningitis AT sadienamani prospectivestudyofriskfactorsforneurologicalcomplicationsinchildhoodbacterialmeningitis AT zvonkomilenkovic prospectivestudyofriskfactorsforneurologicalcomplicationsinchildhoodbacterialmeningitis AT bulezakoci prospectivestudyofriskfactorsforneurologicalcomplicationsinchildhoodbacterialmeningitis |