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Bacterial meningitis in infants: the epidemiology, clinical features, and prognostic factors

Chin-Jung Chang1, Wen-Neng Chang, Li-Tung Huang

  • 1Department of Pediatrics, Chang Gung Memorial Hospital-Jiayi, Jiayi, Taiwan.

Brain & Development
|March 20, 2004
PubMed

Insights

Bacterial meningitis in infants shows shifting pathogens, with E. coli increasingly common. Despite an 11% mortality rate, 43% of cases had poor outcomes, highlighting the need for early diagnosis and treatment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Bacterial meningitis remains a significant cause of morbidity and mortality in infants.
  • Understanding pathogen prevalence and associated outcomes is crucial for effective treatment strategies.

Purpose of the Study:

  • To analyze trends in bacterial meningitis pathogens and outcomes in infants over a 16-year period.
  • To identify factors associated with treatment failure and neurological complications.

Main Methods:

  • Retrospective study of 80 infants (30-365 days old) with culture-proven bacterial meningitis from 1986-2001.
  • Analysis of pathogen distribution, mortality rates, treatment failures, and neurological complications.
  • Logistic regression to identify independent predictors of treatment failure.

Main Results:

  • Salmonella species, Streptococcus agalactiae, Escherichia coli, and Haemophilus influenzae were the most prevalent pathogens.
  • E. coli replaced Salmonella as the leading pathogen in the second study period, with Salmonella meningitis decreasing.
  • Overall mortality was 11%, but 43% of patients experienced poor outcomes. Neurological complications were common, particularly with H. influenzae, S. pneumoniae, and Salmonella species.
  • Decreased level of consciousness was the only independent predictor of treatment failure.

Conclusions:

  • Shifting pathogen landscape in infant bacterial meningitis necessitates updated treatment guidelines.
  • High rates of treatment failure and neurological complications underscore the importance of early diagnosis and appropriate antibiotic selection.
  • Addressing both pathogen eradication and neurological sequelae is essential for improving survival and outcomes.

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