Bacterial Meningitis in Children: Neurological Complications, Associated Risk Factors, and Prevention

Abstract

Bacterial meningitis is a devastating infection, with a case fatality rate of up to 30% and 50% of survivors developing neurological complications. These include short-term complications such as focal neurological deficit and subdural effusion, and long-term complications such as hearing loss, seizures, cognitive impairment and hydrocephalus. Complications develop due to bacterial toxin release and the host immune response, which lead to neuronal damage. Factors associated with increased risk of developing neurological complications include young age, delayed presentation and Streptococcus pneumoniae as an etiologic agent. Vaccination is the primary method of preventing bacterial meningitis and therefore its complications. There are three vaccine preventable causes: Haemophilus influenzae type b (Hib), S. pneumoniae, and Neisseria meningitidis. Starting antibiotics without delay is also critical to reduce the risk of neurological complications. Additionally, early adjuvant corticosteroid use in Hib meningitis reduces the risk of hearing loss and severe neurological complications.

Endogenous α7 nAChR Agonist SLURP1 Facilitates Escherichia coli K1 Crossing the Blood-Brain Barrier

“…Despite the widespread use of antibiotics, sepsis and meningitis remain to be severe complications in premature neonates, leading to high morbidity and mortality (1)(2)(3). Thus, developing more targeted therapeutic methods for meningitis is urgently needed.…”

World Meningitis Day and the World Health Organization’s roadmap to defeat bacterial meningitis in the COVID-19 pandemic era

“…The largest burden of meningitis is seen in children up to 5 years old and in low-and middle-income countries, especially in the meningitis belt of sub-Saharan Africa. However, outbreaks of the disease occur in all continents of the world, showing that this is a matter of global public health (Zainel et al, 2021;Wall et al, 2021).…”

“…Vaccination is a key aspect of the World Health Organization's roadmap. Introduction and expansion of vaccination against meningococcus, pneumococcus and H. influenzae has drastically reduced meningitis-related cases (Rodgers et al, 2020;Zainel et al, 2021;Wall et al, 2021). Nearly 50% and 70% of countries worldwide currently have high coverage (80%) for pneumococcal and H. influenzae vaccines, respectively (International Vaccine Access Center (IVAC, 2021).…”

“…Nearly 50% and 70% of countries worldwide currently have high coverage (80%) for pneumococcal and H. influenzae vaccines, respectively (International Vaccine Access Center (IVAC, 2021). However, the case fatality rate of meningitis has remained the same, and most of these vaccines confer protection to only a portion of serogroups or serotypes that can be found within these bacterial species, raising concerns about the emergence of non-vaccine variants (Zainel et al, 2021;Wall et al, 2021). In addition, antimicrobial resistance is an emerging and concerning aspect in most, if not all, of the 4 major meningitisrelated pathogens (WHO, 2017;CDC, 2019).…”

Editorial for the Special Issue: Bacterial Meningitis—Epidemiology and Vaccination

“…Zainel et al [ 16 ] highlighted neurological complications from bacterial meningitis in children such as hearing loss, cognitive impairment, and epilepsy, as well as the importance of prompt effective treatment regimens in improving outcomes. A key component of prompt treatment is rapid accurate diagnosis of meningitis through bedside tests that can be applicable in low- and middle-income countries.…”