Related Experiment Video
Updated: Jul 3, 2025
Constructing Mutants in Serotype 1 Streptococcus pneumoniae strain 519/43
Published on: September 11, 2020
Clinical Picture and Risk Factors for Poor Outcome in Streptococcus pneumoniae Meningitis of Childhood on Three
Pinja-Liisa Mbakwe1, Irmeli Roine2, Manuel Leite Cruzeiro3
1From the Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Insights
Streptococcus pneumoniae meningitis (SpM) is a severe global health issue. Clinical factors like low Glasgow Coma Score and young age predict poor outcomes, aiding early intervention for children with SpM.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Streptococcus pneumoniae meningitis (SpM) poses a significant global health burden, especially in low- and middle-income countries.
- Identifying high-risk patients for mortality and sequelae is crucial for targeted interventions and intensive care allocation.
- This research focuses on identifying risk factors that do not necessitate laboratory diagnostics.
Purpose of the Study:
- To identify clinical predictors of mortality and severe sequelae in children with Streptococcus pneumoniae meningitis (SpM).
- To compare the outcomes of SpM with other bacterial meningitis etiologies.
- To highlight geographical disparities in SpM outcomes.
Main Methods:
- Secondary analysis of prospectively collected data from five clinical trials on childhood bacterial meningitis (1984-2017).
- Analysis of SpM cases across different study sites, including Latin America and Angola.
- Identification of predictors for poor outcome (death or severe sequelae) using statistical analysis.
Main Results:
- SpM cases (n=505) showed a doubled death rate (33%) and tripled poor outcome rate (15%) compared to other etiologies.
- Independent predictors for death in SpM included Glasgow Coma Score <13 and prior antibiotic use in Angola.
- Predictors for poor outcome included age <1 year, Glasgow Coma Score <13, seizures (Latin America), and prior antibiotic use (Angola).
Conclusions:
- Streptococcus pneumoniae meningitis is significantly more severe than other bacterial meningitis types.
- Children in Angola faced a substantially higher risk of poor outcomes compared to those in Finland.
- Clinical factors identifiable upon admission are effective in identifying SpM patients at high risk for adverse outcomes.
Background:
Streptococcus pneumoniae meningitis (SpM) remains a major health burden worldwide, particularly in low- and middle-income countries. Identifying the patients at highest risk for mortality and disabling sequelae may reveal potentially avoidable predisposing factors and identify patients most in need of intensive care. We searched for factors that do not require laboratory facilities.
Methods:
This study was a secondary analysis of prospectively collected data from 5 clinical trials of childhood bacterial meningitis on 3 continents between 1984 and 2017. SpM cases were analyzed by study site and predictors for poor outcome (death or severe sequelae) were identified from the whole series, Latin America and Angola.
Results:
Among a total of 1575 children (age range: 2 months to 15 years), 505 cases were due to pneumococci. Compared to other etiologies, SpM doubled the death rate (33% vs. 17%) and tripled poor outcome (15% vs. 6%). In SpM, Glasgow Coma Score <13 [odds ratio (OR): 4.73] and previous antibiotics in Angola (OR: 1.70) were independent predictors for death. Predictors for poor outcome were age <1 year (OR: 2.41) and Glasgow Coma Score <13 (OR: 6.39) in the whole series, seizures in Latin America (OR: 3.98) and previous antibiotics in Angola (OR: 1.91). Angolan children had a 17-fold increased risk for poor outcome when compared with Finnish children ( P = 0.011).
Conclusions:
Our study proved the severity of SpM when compared with other etiologies. The outcome was especially poor in Angola. Most patients at risk for poor outcome are easily identified by clinical factors on admission.
More Related Videos
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:29Pneumonia II: Pathophysiology