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Published on: February 23, 2014
The burden of pneumococcal meningitis in Austrian children between 2001 and 2008
D S Klobassa1, B Zoehrer, M Paulke-Korinek
1Department of General Paediatrics, University Clinic of Paediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria.
Insights
Pneumococcal meningitis in Austrian children (2001-2008) resulted in significant mortality and long-term sequelae, including motor and hearing impairments. While motor deficits showed some improvement, hearing impairments persisted.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Pneumococcal meningitis poses a significant public health threat to young children.
- Understanding the burden and long-term outcomes of pneumococcal meningitis is crucial for effective prevention and management strategies.
Purpose of the Study:
- To evaluate the incidence, clinical outcomes, and long-term sequelae of pneumococcal meningitis in Austrian children under five years old between 2001 and 2008.
Main Methods:
- A prospective multicenter surveillance study was conducted on hospitalized invasive pneumococcal infections.
- Clinical outcomes were retrospectively analyzed at hospital discharge and during long-term follow-up.
- Neuroimaging was used to identify cerebral lesions in children with motor deficits.
Main Results:
- 74 cases of pneumococcal meningitis were identified, with a mean annual incidence of 2.3 per 100,000 children under five.
- At discharge, 8.8% of children died, and 35.1% had sequelae, including motor and hearing impairments.
- Long-term follow-up revealed persistent hearing impairments in 22.5% of children, though motor deficits showed some improvement.
Conclusions:
- Pneumococcal meningitis is associated with high mortality and severe long-term sequelae in children.
- Improvements in motor impairment were observed on long-term follow-up, but hearing impairment remained a significant long-term deficit.
Unlabelled:
The present study was conducted to evaluate the burden of pneumococcal meningitis in Austrian children between 2001 and 2008. Clinical outcome was retrospectively analyzed both on discharge and on follow-up investigations. This study was based on a prospective multicentre surveillance study on hospitalized invasive pneumococcal infections in Austrian children with a total annual "study population" of about 399,000 children aged below 5 years per year. Between 2001 and 2008, 74 cases of pneumococcal meningitis were identified in children aged below 5 years. The mean annual incidence rate for pneumococcal meningitis was 2.3 per 100,000 children in this age group. In 57/74 children (mean age on admission 14.5 ± 13.3 months), outcome data on hospital discharge were available: 5 deaths (8.8%), 20 children (35.1%) with sequelae and 32 children (56.1%) without sequelae were observed. Sequelae on discharge included motor impairment in 8 children (14.0%), hearing impairment in 9 children (15.8%) and/or other complications in 14 children (24.6%). In 7/8 children with motor deficits, matching cerebral lesions were identified by neuroimaging: cerebral infarction in five children, cerebral vasculitis and cerebral abscess in one child each. In 40/57 children, long-term outcome (18.9 ± 20.2 months after discharge) could be assessed: 1 child (2.5%) died 9 months after hospital discharge, 11 children (27.5%) had one or two long-term sequelae and 28 children (70.0%) had no sequelae. Long-term sequelae included motor impairment in three children (7.5%), hearing impairment in nine children (22.5%) and other deficits in two children (5.0%).
Conclusion:
Our study confirms that pneumococcal meningitis causes high mortality and severe long-term sequelae. On long-term follow-up, we observed improvements of motor impairment, but not of hearing impairment.
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