荷兰儿童复发性细菌性脑膜炎:一项全国性的监测研究
Linde Snoek1,2, Merel N van Kassel1,2, Diederik L H Koelman1,2
1Department of Neurology, Amsterdam University Medical Centre location AMC, University of Amsterdam, Amsterdam, Netherlands.
BMJ open
|December 30, 2023
概括
在荷兰,儿童细菌性脑膜炎的复发率为0.6%. 虽然第一次发作的发病率下降,但复发发病仍保持稳定,随着年龄的增长和大肠杆菌感染的风险增加.
科学领域:
- 儿童传染病 儿童传染病
- 流行病学 流行病学
- 细菌学 细菌学是一门学科.
背景情况:
- 细菌性脑膜炎仍然是儿童发病的一个重要原因.
- 了解复发模式对于公共卫生战略和临床管理至关重要.
- 之前的研究表明复发率各不相同,因此需要更新数据.
研究的目的:
- 估计荷兰儿童培养阳性细菌脑膜炎的复发率.
- 分析随着时间的推移,第一次和反复发作的发病率的趋势.
- 确定与儿童复发性细菌性脑膜炎相关的预测因素.
主要方法:
- 一项全国性的监测研究,利用来自荷兰细菌脑膜炎参考实验室的数据.
- 包括1987年至2019年间有9731名患有第一个细菌性脑膜炎发作的儿童.
- 复发定义为后续发作>28天或由不同的病原体引起;使用回归模型分析的发病率和风险因素.
主要成果:
- 总共有0.6% (63/9731) 的儿童患有复发性细菌性脑膜炎.
- 第一次脑膜炎发作的发生率从1988-2003年至2004-2019年显著下降 (IRR为0.25).
- 复发发作的发生率保持不变 (IRR为0.65),老年和最初感染大肠杆菌是复发的重要风险因素.
结论:
- 荷兰儿童细菌脑膜炎的整体复发率很低,为0.6%.
- 观察到第一个脑膜炎发作的发生率大幅下降,与复发发作的稳定发病率形成鲜明对比.
- 诸如第一个发作时的年龄较大和大肠杆菌感染等因素与复发性脑膜炎的风险增加有关.
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