Clinical-epidemiological characteristics of acute bacterial meningitis in children of Khmelnitskyi region (Podilsky region, Ukraine): fifteen-year-long
DOI:
https://doi.org/10.15574/SP.2022.125.35Keywords:
children, bacterial meningitis, epidemiology, etiologyAbstract
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.
References
Abdinia B, Rezaee MA, Oskouie SA. (2014). Etiology and Antimicrobial Resistance Patterns of Acute Bacterial Meningitis in Children: A 10-Year Referral Hospital-Based Study in Northwest Iran. Iran Red Crescent Med J. 16 (7): 17616. https://doi.org/10.5812/ircmj.17616; PMid:25237583 PMCid:PMC4166102
Alam AA, Morad WS, Bahbah MH, Labeeb AZ. (2013). Epidemiological and Clinical Study of Bacterial Meningitis in Menoufiya Governorate. Journal of Medical Science and Clinical Research. 1 (3): 130-140.
Antipkin YuG, Marushko RV, Dudina EA. (2021). Evolution of infant mortality in Ukraine. Modern Pediatrics. Ukraine. 1 (113): 6-14. https://doi.org/10.15574/SP.2021.113.6
Antoniuk SA, Hamdar F, Ducci RD, Kira ATF, Cat MNL, R da Cruz C. (2011). Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae. J Pediatr (Rio J). 87 (6): 535-540. https://doi.org/10.2223/JPED.2138; PMid:22170227
Atti MC, Esposito S, Parola L, Ravà L, Gargantini G, Longhi R, GSAQ working group. (2014). In-hospital management of children with bacterial meningitis in Italy. Italian Journal of Pediatrics. 40: 87. https://doi.org/10.1186/s13052-014-0087-1; PMid:25584885 PMCid:PMC4247725
Berberian G, Guadalupe Pérez M, Epelbaum C, Del Carmen Ceinos M, Lopardo H, Rosanova MT. (2014). Pneumococcal meningitis: A 12 year experience in a children's hospital prior to the universal immunization with a conjugate vaccine. Arch Argent Pediatr. 112 (4): 332-336. https://doi.org/10.5546/aap.2014.332; PMCid:PMC4415275
Biaukula VL, Tikoduadua L, Azzopardi K, Temple B, Richmond P, Robins-Browne R, Mulholland EK, Russell FM. (2012). Meningitis in children in Fiji: etiology, epidemiology, and neurological sequelae. International Journal of Infectious Diseases. 16 (4): 289-295. https://doi.org/10.1016/j.ijid.2011.12.013; PMid:22342257
Braun JS, Hoffmann O, Schickhaus M, Freyer D, Dagand E, Bermpohl D, Mitchell TJ, Bechmann I, Weber JR. (2007). Pneumolysin causes neuronal cell death through mitochondrial damage. Infection and Immunity. 75 (9): 4245-4254. https://doi.org/10.1128/IAI.00031-07; PMid:17562768 PMCid:PMC1951198
Castelblanco RL, Lee M, Hasbun R. (2014). Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study. Lancet Infect Dis. 14 (9): 813-819. https://doi.org/10.1016/S1473-3099(14)70805-9
Chaudhuri A, Martin PM, Kennedy PGE, Andrew Seaton R, Portegies P, Bojar M, Steiner I, for the EFNS Task Force. (2008). EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur. J. Neurol. 15 (7): 649-655. https://doi.org/10.1111/j.1468-1331.2008.02193.x; PMid:18582342
Erum A, Zafar MZ, Rasool S, Ali Z, Yousaf K, Razzaq S, Farooq U, Gulbaqir HM, Tariq M. (2017). Different Incidences of Acute Bacterial Meningitis in Children of Central Punjab in Pakistan. Journal of Neurology and Neuroscience. 8 (4): 231. https://doi.org/10.21767/2171-6625.1000231
Ghotaslou R, Sefidan FY, Salahi-Eshlaqi B, Ebrahimzadeh-Leylabadlo H. (2015). Etiology of Acute Bacterial Meningitis in Iran: a Systematic Review. Acta Med Iran. 53 (8): 454-461.
Guo LY, Zhang ZX, Wang X, Zhang P-P, Shi W, Yao K-H, Liu L-L, Liu G, Yang Y-H. (2016). Clinical and pathogenic analysis of 507 children with bacterial meningitis in Beijing, 2010-2014. Int J Infect Dis. 50: 38-43. https://doi.org/10.1016/j.ijid.2016.07.010; PMid:27452172
Joardar S, Joardar GK, Mandal PK, Mani S. (2012). Meningitis in Children: A Study in Medical College & Hospital, Kolkata. Bangladesh J Child Health. 36 (1): 20-25. https://doi.org/10.3329/bjch.v36i1.13031
Kim KS. (2010). Acute bacterial meningitis in infants and children. Lancet Infect Dis. 10 (1): 32-42. https://doi.org/10.1016/S1473-3099(09)70306-8
Koroleva IS, Beloshickij GV, Koroleva MA, Zakroeva IM, Spirihina LV, Mironov KO, Shipulin GA. (2013). Meningokokkovaya infekciya i gnojnye bakterialnye meningity v Rossijskoj Federacii: desyatiletnee epidemiologicheskoe nablyudenie. Epidemiologiya i infekcionnye bolezni 2: 15-20.
Usacheva EV, Dralova AA, Pakholchuk TN, Konakova OV, Silina EA. (2020). Features of the course of serious meningites of herpetic ethiology. Modern Pediatrics. Ukraine. 2 (106): 38-42. https://doi.org/10.15574/SP.2020.106.38
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