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Bacterial meningitis in children with an abnormal craniocerebral structure
Jiali Pan1, Wei Xu1, Wenliang Song1
1Department of Pediatrics, ShengJing Hospital of China Medical University, Shenyang, China.
Insights
Children with abnormal craniocerebral structures and bacterial meningitis had lower mortality but more neurological issues. Pathogens were often nosocomial and multidrug-resistant.
Area of Science:
- Pediatric Infectious Diseases
- Neuroscience
- Critical Care Medicine
Background:
- Bacterial meningitis in children presents unique challenges, especially those with pre-existing abnormal craniocerebral structures.
- Understanding the specific pathogens, clinical course, and outcomes in this vulnerable population is crucial for effective management.
Purpose of the Study:
- To investigate the causative pathogens, clinical characteristics, and outcomes of bacterial meningitis in children with abnormal craniocerebral structures.
- To compare these factors between children with and without abnormal craniocerebral structures.
Main Methods:
- A retrospective single-center study included 207 children (29 days to 14 years) diagnosed with bacterial meningitis.
- Patients were categorized into complex (abnormal craniocerebral structure) and simple (normal structure) groups.
- Data on demographics, clinical presentation, laboratory results, imaging, treatments, and outcomes were analyzed.
Main Results:
- The complex group (46 patients) exhibited a lower mortality rate (6.5% vs. 11.2%) and less frequent positive blood cultures (13.0% vs. 34.8%) compared to the simple group (161 patients).
- However, the complex group had a higher incidence of neurological sequelae (80.4% vs. 53.4%) and nosocomial infections (54.3% vs. 3.1%).
- Multidrug-resistant bacteria were prevalent in the complex group (62.5%).
Conclusions:
- Bacterial meningitis in children with abnormal craniocerebral structures is associated with reduced bloodstream infections and mortality but increased neurological sequelae.
- Nosocomial and multidrug-resistant pathogens are more common in this complex group.
- These findings highlight the need for tailored management strategies for pediatric bacterial meningitis patients with underlying structural abnormalities.
Background:
We studied the causative pathogens, clinical characteristics, and outcome of bacterial meningitis in children with an abnormal craniocerebral structure.
Methods:
A retrospective single-center study was conducted on children aged in the range of 29 days to 14 years by using data obtained from the pediatric intensive care unit in Shengjing Hospital between January 2014 and August 2021. All children were diagnosed with bacterial meningitis. They were divided into complex and simple groups by taking into account the presence of an abnormal craniocerebral structure before they contracted bacterial meningitis. We collected data on demographics, clinical presentations, laboratory results, imaging studies, treatments, and outcomes.
Results:
A total of 207 patients were included in the study (46 in the complex group and 161 in the simple group). Patients in the complex group had a lower mortality rate (6.5% vs. 11.2%, p < 0.05), positive blood culture (13.0% vs. 34.8%; p < 0.05), multiple organ dysfunction syndrome (0% vs. 9.3%; p < 0.05), and shock (2.2% vs. 9.3%; p = 0.11). These patients were more often detected with neurological sequelae (80.4% vs. 53.4%; p < 0.05), cerebrospinal fluid drainage (50% vs. 15.5%; p < 0.05), nosocomial infection (54.3% vs. 3.1%; p < 0.05), and multidrug-resistant bacteria (62.5% vs. 55.6%, p = 0.501). In patients in the simple group, infection was mostly confined to the nervous system.
Conclusion:
Bacterial meningitis patients with an abnormal craniocerebral structure had fewer bloodstream infections, lower mortality rates, and higher incidence rates of neurological sequelae. Pathogens were more likely to be nosocomial and multidrug-resistant bacteria.
