Epidemiology of Pediatric Pneumococcal Meningitis and Bacteremia in Latin America and the Caribbean

Ciapponi, Agustín; Elorriaga, Natalia; Rojas, Juan Ignacio; Romano, Marina; Martí, Sebastián García; Bardach, Ariel; Ruvinsky, Silvina

doi:10.1097/inf.0000000000000363

Cited by 24 publications

(16 citation statements)

References 54 publications

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“…Early treatment of bacterial meningitis can prevent serious complications such as hearing loss, memory difficulty, learning disabilities, brain damage, seizures and death (1)(2)(3). Meningitis can be life-threatening and the condition is classified as a medical emergency.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Meningitis Studied at a University Hospital in Zahedan, South-Eastern Iran

et al. 2015

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Background:Meningitis is an inflammation of the membranes, which surround the brain and spinal cord. Early treatment of bacterial meningitis can prevent serious complications. In the last two decades, three vaccines have been developed against the three main bacterial species implicated in meningitis of children in western countries and vaccine-preventable invasive bacterial meningitis has decreased substantially in the past few years. However, none of the developed vaccines are part of our childhood immunization schedule. Objectives: This study aimed to search the epidemiology of meningitis in Zahedan. Patients and Methods:In this cross-sectional survey, we studied all patients with meningitis for ten years, from May 2004 to May 2014, who had been referred to our hospital. The patients were evaluated according to their sex, age, clinical features, risk factors, pathogenic microorganisms, form of infection (acute or chronic) and clinical outcome. Results: Among the 53 patients with meningitis (47% females; 53% males with mean age 36 years) 47 cases (83%) had acute meningitis and six cases (17%) had chronic meningitis (four cases of tuberculosis and two cases of brucellosis). From the 47 cases with acute meningitis, only one case had a positive cerebrospinal fluid (CSF) culture for meningococci and 46 patients had negative CSF culture. The most common clinical symptoms was fever and headache (90%) and the least was seizure (9%). Mortality rate was 7.5% (4 cases). There were no significant risk factors except for two patients with acute meningitis and two cases with chronic meningitis. Conclusions: According to negative CSF cultures in acute meningitis, CSF culture using the BACTEC automated system and specific viral tests is recommended for detection of the etiological agents of viral and bacterial meningitis, particularly in the Iranian population where patients use antibiotics without prescription.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Meningitis Studied at a University Hospital in Zahedan, South-Eastern Iran

et al. 2015

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“…En contraste con la meningitis en la edad preescolar, los más frecuentes son S. pneumoniae y N. meningitidis y en menor medida el H. influenzae, por el impacto del programa ampliado de inmunización (27,28) . Adicional al cultivo de LCR, el hemocultivo se realizó en la mayoría de la población, lo cual permitió identificar con mayor probabilidad al microorganismo en su fase de diseminación hematógena previa a la invasión meníngea; como se reporta en otros estudios como el de Ciapponi et al, existe un alto porcentaje de bacteriemia en niños con MB especialmente menores de 5 años (29,30) .…”

Section: Discussionunclassified

Características clínicas, epidemiológicas y manejo terapéutico de la meningitis pediátrica en dos instituciones de Medellín, Colombia

et al. 2018

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Introducción: La meningitis es una emergencia médica que requiere diagnóstico y tratamiento oportuno para evitar complicaciones. Objetivo: Determinar las características clínicas, epidemiológicas y el manejo terapéutico de meningitis en la primera infancia. Materiales y métodos: Estudio transversal que evaluó menores hasta los seis años de edad con meningitis bacteriana o aséptica en dos centros de Medellín, 2010 – 2013. Se recolectaron características clínicas, paraclínicas y terapéuticas. Las variables cualitativas se describieron mediante frecuencias absolutas y relativas y las cuantitativas con mediana y rango intercuartílico. Se exploró diferencias en las características de los pacientes según grupo de edad, mediante la prueba Chi-cuadrado o Fisher. Resultados: De 56 pacientes, 33(58,9%) eran del sexo masculino; 26(46,4%) presentaron meningitis bacteriana, 20(35,7%) aséptica y 10(17,9%) indeterminada; 36(64,3%) fueron mayores de dos meses, con manifestaciones clínicas inespecíficas (fiebre e irritabilidad). Se aislaron principalmente microorganismos Gram negativos en hemocultivos y Gram positivos en líquido cefalorraquídeo. El tratamiento antibiótico más frecuente fue cefalosporinas de tercera-generación en 13(65%) menores de 2 meses y 28(77,8%) mayores. Fallecieron dos pacientes y seis presentaron complicaciones. Conclusiones: la meningitis bacteriana fue la más frecuente en menores de un año. El tratamiento combinado es ideal para garantizar un adecuado cubrimiento y evitar complicaciones.

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“…The next important observation of our chart review is the proportionately higher death rates in diarrheal children under five years of age with Streptococcal bacteremia compared to those without Streptococcal bacteremia; although, this is statistically insignificant. However, a number of previous studies had found the association of higher case-fatality rates with Streptococcal bacteremia [ 38 , 39 ]. The failure of attaining the significant difference in deaths in our study might be due to selection of sick controls as they all had diarrhea and/or other co-morbidities such as edematous malnutrition and severe sepsis.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Streptococcal Bacteremia in Diarrheal Children under Five Years of Age and Their Outcome in an Urban Hospital in Bangladesh

et al. 2016

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BackgroundAlthough Streptococcal bacteremia is common in diarrheal children with high morbidity and mortality, no systematic data are available on Streptococcal bacteremia in diarrheal children. We sought to evaluate the factors associated with Streptococcal bacteremia in diarrheal children under five years of age and their outcome.MethodsWe used an unmatched case-control design to investigate the associated factors with Streptococcal bacteremia in all the diarrheal children under five years of age through electronic medical record system of Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh. We had simultaneously used a retrospective cohort design to further evaluate the outcome of our study children. All the enrolled children had their blood culture done between January 2010 and December 2012. Comparison was made among the children with (cases = 26) and without Streptococcal bacteremia (controls = 78). Controls were selected randomly from hospitalized diarrheal children under five years of age.ResultsCases had proportionately higher deaths compared to controls, but it was statistically insignificant (15% vs. 10%, p = 0.49). The cases more often presented with severe dehydration, fever, respiratory distress, severe sepsis, and abnormal mental status compared to the controls (for all p<0.05). In the logistic regression analysis, after adjusting for potential confounders, it has been found that Streptococcal bacteremia in diarrheal children under five years of age was independently associated with nutritional edema (OR: 5.86, 95% CI = 1.28–26.80), hypoxemia (OR: 19.39, 95% CI = 2.14–175.91), fever (OR: 4.44, 95% CI = 1.13–17.42), delayed capillary refill time (OR: 7.00, 95% CI = 1.36–35.93), and respiratory distress (OR: 2.69, 95% CI = 1.02–7.12).Conclusions and SignificanceThe results of our analyses suggest that diarrheal children under five years of age presenting with nutritional edema, hypoxemia, fever, delayed capillary refill time, and respiratory distress may be at risk of Streptococcal bacteremia. It underscores the importance of identification of these simple clinical parameters for the prompt recognition and management in order to reduce the morbidity and death of such children especially in resource limited settings.

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Epidemiology of Pediatric Pneumococcal Meningitis and Bacteremia in Latin America and the Caribbean

Cited by 24 publications

References 54 publications

Epidemiology of Meningitis Studied at a University Hospital in Zahedan, South-Eastern Iran

Epidemiology of Meningitis Studied at a University Hospital in Zahedan, South-Eastern Iran

Características clínicas, epidemiológicas y manejo terapéutico de la meningitis pediátrica en dos instituciones de Medellín, Colombia

Factors Associated with Streptococcal Bacteremia in Diarrheal Children under Five Years of Age and Their Outcome in an Urban Hospital in Bangladesh

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