Clinical Characteristics and Prognostic Factors in Childhood Bacterial Meningitis: A Multicenter Study

Türel, Özden; Yıldırım, Canan; Yüksel, Yılmaz; Külekçi, Sezer; Akdaş, Ferda; Bakır, Mustafa

doi:10.5152/balkanmedj.2012.092

Cited by 14 publications

(13 citation statements)

References 27 publications

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“…This happens especially in cases with bacterial biofilm formation, where bacterial metabolism is amplified and thus the host immune defense system is more hampered by these more virulent bacterial species (2,10). In such cases the infection process, from upper respiratory tract mucus, propagates outside the initial localization and leads to complications such as middle ear infections or pneumonia, in some cases even it can lead to bacteremia or infections of central nervous system (2,18,(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Microbiological Features of Upper Respiratory Tract Infections in Bulgarian Children for the Period 1998-2014

et al. 2016

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Background: Across the globe, upper respiratory tract infections (URTIs) are the most prevalent cause of morbidity in childhood. Aims: The aim of our study is to analyze the incidence and etiology of bacterial URTIs in Bulgarian children, as well as the increasing antimicrobial resistance to the most common etiologic agents over a period of 17 years. Study Design: Retrospective study. Methods:The study material comprised the data from 4768 patients (aged 1-16 years) with URTI during the period from 1998-2014. Specific microbiology agent detection was performed by culture examination. Susceptibilities to the investigated pathogens were determined by the disk diffusion method and minimal inhibitory concentration according to the criteria of the Clinical and Laboratory Standards Institute (CLSI). Polymerase chain reaction was used to detect the presence of β-lactam resistance genes. Results: We identified the following as the most common URTI bacterial pathogens: Streptococcus pneumoniae (40.94%), Streptococcus pyogenes (34.16%), Haemophilus influenzae (44.23%), Moraxella catarrhalis (39.19%) and Staphylococcus aureus (23.88%). In more than 70% of cases, a polymicrobial etiology was found. The most commonly affected individuals were pre-school-aged children, which accounted for more than 36% of all patients. During the study period, a dramatic increase in resistance to antibiotic agents was observed. The most frequent types of resistance were the enzymatic inactivation of penicillins and cephalosporins (close to 100% in staphylococci and moraxellae) and inducible macrolide-lincozamide resistance (about 20% of Gram-positive cocci). Conclusion: Due to mandatory immunization against pneumococci and H. influenzae in Bulgaria and the vast expanding resistance to the most popular antimicrobial agents changes in the etiology of URTI have recently been noted. Regular analysis of this etiological dynamic and the antimicrobial resistance of respiratory pathogens is important for choosing the correct therapy and successful treatment.

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Section: Discussionmentioning

confidence: 99%

Microbiological Features of Upper Respiratory Tract Infections in Bulgarian Children for the Period 1998-2014

et al. 2016

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“…Although bacterial meningitis is relatively rare, early diagnosis and treatment are of particular importance for preventing serious neurological sequelae or death. [24][25][26] Discrimination between aseptic and bacterial meningitis cases in the early period is important, as it reduces unnecessary hospitalization and antibiotic use. 6,27 Identifying the serum PCT level is recommended as an important biomarker in discriminating between bacterial and aseptic meningitis.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Clinical and Laboratory Findings in Childhood Meningitis

Emiroğlu

Keşli

Kilicaslan

2019

J Pediatr Infect Dis

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Objective Acute meningitis in childhood is a serious infectious disease that requires immediate medical assessment to ensure appropriate treatment and healthy outcomes. The aim of this retrospective study was to evaluate clinical and laboratory findings in the diagnosis of acute meningitis in children. Materials and Methods Between February 2011 and March 2013, 258 children aged between 1 month and 18 years who were admitted to Konya Training and Research Hospital, Turkey, with clinically suspected meningitis and undergoing lumbar puncture were enrolled in the study. Patient charts were reviewed using a standardized data collection tool. Fifty-nine patients were excluded because of incomplete data or because they did not meet the enrollment criteria. Further statistical analysis was conducted on the remaining 199 patients. The diagnostic values of clinical and laboratory findings for acute meningitis were investigated. IBM SPSS 21.0 for Windows was used for the statistical analysis. Results Of the 199 patients (61.3% male; median age: 24 months), 101 (50.8%) were diagnosed with meningitis. A definitive diagnosis of bacterial meningitis was made in 16 patients, while 5 patients had probable bacterial meningitis. In addition, 80 patients diagnosed as aseptic meningitis and 47 of these patients had human enterovirus meningitis. Headache was more common in patients with meningitis. In patients without meningitis, the most common complaints were seizures or seizures accompanied by fever. Erythrocyte sedimentation rates (ESR), levels of cerebrospinal fluid protein, and cell counts in cerebrospinal fluid examinations were higher in the meningitis group. C-reactive protein, ESR, and procalcitonin higher than 22.55 mg/L, 36.5 mm/hour, and 6.795 mg/mL, respectively, indicated bacterial meningitis. Conclusion Our results showed that a combination of clinical and laboratory markers could facilitate recognition of bacterial meningitis in children.

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“…(15,16) The frequency of complications was significantly higher among children with bacterial ME compared to those with viral variety of the disease, which is in accordance with several published reports. (17)(18)(19)(20)(21)(22) This could be partially explained by the fact that the inflammatory response in the subarachnoid space as a result of bacterial infection is more severe than that due to viral infections. (23) The significantly higher frequency of ME complications among children less than one year of age is consistent with that reported by Gomes et al, (24) who reported that complications were more predominant among Brazilian children aged less than one year of age (71%).…”

Section: Discussionmentioning

confidence: 99%

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

Bawazeer¹

2019

YJMS

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Objective: To determine the types and frequencies of complications associated with acute meningoencephalitis (ME) among children admitted to hospitals in Aden, Yemen. Methods: This descriptive cross-sectional study was conducted among 60 children (1 month-14 years of age) admitted to AL-Wahda Teaching Hospital in Aden with acute ME (viral or bacterial) over the period from January to June 2010. Data were collected using a pre-designed questionnaire, and data were presented as frequencies and percentages and analyzed using appropriate statistical tests. Differences or associations between categorical variables were considered statistically significant at P values <0.05. Results: ME complications were significantly higher among children aged less than one year compared to those aged one year or older (58.8% vs. 38.5%, respectively) and among those with bacterial ME compared to those with viral ME (79.2% vs. 30.6%, respectively). The complications were also significantly higher among children with history of illness for three or more days before their admission compared to those having been ill for less than three days (65.8 vs. 22.7%, respectively). In addition, children aged less than two years not exclusively breastfed were more prone to ME complications compared to those exclusively breastfed (93.5% vs. 50.0%, respectively). Increased intracranial pressure (ICP), anemia and hypoglycemia were the three most frequent ME complications among children admitted to Al-Wahda Teaching Hospital, being observed in 53.3%, 50.0% and 43.3% of patients, respectively. Increased ICP was significantly higher among children aged five years or older compared to those aged less than five years (88.9% vs. 47.1%, respectively). In contrast, anemia and hyperglycemia were significantly higher among children aged less than five years (56.9% and 49.0%, respectively) compared to those aged five years or older (11.1% each). Conclusions: ME complications are significantly higher among children aged less than one year, infected with bacterial ME, with history of illness for three or more days before their admission and not exclusively breastfed. Increased ICP, anemia and hypoglycemia are the three most frequent ME complications, particularly among children with bacterial ME in Aden, followed by focal neurological deficits seizures and cranial nerve palsy. Although increased ICP is significantly higher among children aged five years or older, anemia and hyperglycemia are significantly higher among children aged less than five years. Active measures to promote immunization and exclusive breastfeeding along with early diagnosis and proper treatment are highly recommended. Further large-scale studies are required to study the pattern of complications following acute ME among Yemeni children.

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Clinical Characteristics and Prognostic Factors in Childhood Bacterial Meningitis: A Multicenter Study

Cited by 14 publications

References 27 publications

Microbiological Features of Upper Respiratory Tract Infections in Bulgarian Children for the Period 1998-2014

Microbiological Features of Upper Respiratory Tract Infections in Bulgarian Children for the Period 1998-2014

Diagnostic Value of Clinical and Laboratory Findings in Childhood Meningitis

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

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