Clinical-epidemiological characteristics of acute bacterial meningitis in children of Khmelnitskyi region (Podilsky region, Ukraine): fifteen-year-long

Abstract

Acute bacterial meningitis (ABM) leads to a significant number of complications and high mortality. The aim - to analyze the etiological structure, epidemiological, socio-demographic features and complications in ABM in children of Khmelnitskyi region during 2004-2018. Materials and methods. The analysis of 346 cases of ABM, of which 217 boys and 129 girls was conducted. The etiology of meningitis was determined by bacterioscopy, bacteriological sowing, latex agglutination and polymerase chain reaction. Complications were revealed based on the clinical picture and computed tomography and мagnetic resonance imaging. The processing of the results was carried out using analytical method, t-criterion and constructing 95% confidence interval. Results. The disease started with fever 346 (100%), neck stiffness 289 (83.5%) and vomiting 273 (78.9%), less common, alteration of consciousness 28 (8.1%) and seizures 9 (2.6%). The high level of the cytosis were observed in meningococcal (5801.3±4856.7 cells/mm3) and Hib meningitis (5152.6±4153.1 cells/mm3), the lowest level was in pneumococcal meningitis (2601.0±1839.6 cells/mm3). The highest level of liquor protein was in pneumococcal meningitis (179.0±51.0 mg/dl), and the lowest level was in meningococcal meningitis (102.0±49.0 mg/dl) and Hib meningitis (112.0±56.0 mg/dl). The etiological factor was established in 121 (35.0%) of patients. 52 (15.4%) of patients had neurological complications. Conclusions. The majority (58.1%) of ABM are in children under the age of 3. The main causative agent remains N. meningitidis - 57.9%, the second place is S. pneumoniae - 21.5%, the third Hib - 9.9% of cases. Frequent complications were brain edema 32 (61.5%), seizures 19 (36.5%) and hydrocephalus 8 (15.4%). The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors.