BMC pediatrics · 2025
Clinical features and long-term outcomes of children with pneumococcal meningitis in China: a 10-year single-centre retrospective analysis.
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Li Yixuan, Jian Binglin, Kang Xuekai, Zhang Mengjie, Guo Lingyun, Ning Xue, Zhu Liang, Chen Tianming, Hu Bing, Liu ShuPing, Xiao Haijuan, Guo Xin, Feng Wenya, Dou Zhenzhen, Liu Linlin, Li Qinjing, Liu Bing, Liu Gang
Аннотация
BACKGROUND: Pneumococcal meningitis is a central nervous system infection responsible for high rates of mortality and long-term disability worldwide. We aimed to summarise the clinical characteristics, as well as determine the risk factors for mortality and long-term progression of paediatric pneumococcal meningitis (PM).
METHODS: This retrospective study included children with microbiologically confirmed PM who were admitted to Beijing Children's Hospital between 2012 and 2021. The laboratory examination results and clinical characteristics of the enrolled patients were analysed. All were followed-up with over the phone, and their long-term prognoses were scored based on the Glasgow Outcome Scale-Extended scale. Factors associated with long-term unfavourable outcomes were identified using single-factor and multivariate analyses.
RESULTS: Totally 301 children with PM were included. Only 22 (7.31%) were vaccinated against Streptococcus pneumoniae (SP) prior to disease onset. The median age at admission was 12.00 (7.00-44.08) months. The median hospitalisation length was 22.00 (14.50-33.00) days. A total of 190 patients (63.12%) experienced neurological complications during their clinical course. A total of 278 children were followed up for a median of 61.61 (41.84-85.42) months, 44 (15.83%) died, and 75 (32.05%) of the 234 surviving children experienced sequelae. In terms of their Glasgow Outcome Scale-Extended (GOS-E) Scale scores, there were 199 cases (71.58%) in the good prognosis group (1-2 points) and 79 cases (28.42%) in the poor prognosis group (3-8 points). Multivariate analysis showed that sex, recurrent seizures or convulsive status, muscle tone changes, dyspnoea, and lower peripheral white blood cells (WBCs) count in the acute phase were independent risk factors for poor prognosis (all P < 0.05).
CONCLUSIONS: PM is associated with high rates of fatality and morbidity in children. Approximately 1/3 of children who survive PM experiences neurological sequelae and require long-term rehabilitation training that poses significant burdens on the society and country.
METHODS: This retrospective study included children with microbiologically confirmed PM who were admitted to Beijing Children's Hospital between 2012 and 2021. The laboratory examination results and clinical characteristics of the enrolled patients were analysed. All were followed-up with over the phone, and their long-term prognoses were scored based on the Glasgow Outcome Scale-Extended scale. Factors associated with long-term unfavourable outcomes were identified using single-factor and multivariate analyses.
RESULTS: Totally 301 children with PM were included. Only 22 (7.31%) were vaccinated against Streptococcus pneumoniae (SP) prior to disease onset. The median age at admission was 12.00 (7.00-44.08) months. The median hospitalisation length was 22.00 (14.50-33.00) days. A total of 190 patients (63.12%) experienced neurological complications during their clinical course. A total of 278 children were followed up for a median of 61.61 (41.84-85.42) months, 44 (15.83%) died, and 75 (32.05%) of the 234 surviving children experienced sequelae. In terms of their Glasgow Outcome Scale-Extended (GOS-E) Scale scores, there were 199 cases (71.58%) in the good prognosis group (1-2 points) and 79 cases (28.42%) in the poor prognosis group (3-8 points). Multivariate analysis showed that sex, recurrent seizures or convulsive status, muscle tone changes, dyspnoea, and lower peripheral white blood cells (WBCs) count in the acute phase were independent risk factors for poor prognosis (all P < 0.05).
CONCLUSIONS: PM is associated with high rates of fatality and morbidity in children. Approximately 1/3 of children who survive PM experiences neurological sequelae and require long-term rehabilitation training that poses significant burdens on the society and country.