High-risk factors associated with refractory childhood bacterial meningitis in Southwest China

作者全名："Wu, JinFeng; Song, XiaoJie; Hu, Yue; Chen, Jin; Jiang, Li"

作者地址："[Wu, JinFeng; Song, XiaoJie; Hu, Yue; Chen, Jin; Jiang, Li] Chongqing Med Univ, Childrens Hosp, Dept Neurol, Chongqing, Peoples R China; [Wu, JinFeng; Song, XiaoJie; Hu, Yue; Chen, Jin; Jiang, Li] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China; [Wu, JinFeng; Song, XiaoJie; Hu, Yue; Chen, Jin; Jiang, Li] Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Wu, JinFeng; Song, XiaoJie; Hu, Yue; Chen, Jin; Jiang, Li] China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China; [Wu, JinFeng; Song, XiaoJie; Hu, Yue; Chen, Jin; Jiang, Li] Chongqing Key Lab Pediat, Chongqing, Peoples R China"

通信作者："Jiang, L (通讯作者)，Chongqing Med Univ, Childrens Hosp, Dept Neurol, Chongqing, Peoples R China.; Jiang, L (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China.; Jiang, L (通讯作者)，Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China.; Jiang, L (通讯作者)，China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China.; Jiang, L (通讯作者)，Chongqing Key Lab Pediat, Chongqing, Peoples R China."

来源：BMC PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000984846000009

JCR分区：Q2

影响因子：2.4

年份：2023

卷号：23

期号：1

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结束页：　

文献类型：Article

关键词：Childhood; Refractory bacterial meningitis; High-risk factors

摘要："BackgroundRefractory bacterial meningitis is acute, develops rapidly, and has higher mortality and morbidity than common bacterial meningitis. This study was undertaken to investigate the high-risk factors related to refractory bacterial meningitis in children with positive pathogens.MethodsWe retrospectively analyzed the clinical data of 109 patients who had bacterial meningitis. The patients were divided into a refractory group (96 patients) and nonrefractory group (13 patients) based on the classification criteria. Seventeen clinical variables on risk factors were extracted and evaluated by univariate and multivariate logistic regression analyses.ResultsThere were 64 males and 45 females. The onset age ranged from 1 month old to 12 years old, and the median age was 181 days old. The pathogenic bacteria included 67 cases of gram-positive (G+) bacteria (61.5%) and 42 cases of gram-negative (G-) bacteria. In patients who were 1 to 3 months old, E. coli was the most common (47.5%), followed by Streptococcus agalactiae and Staphylococcus hemolyticus (10.0%); in patients > 3 months old, S. pneumoniae was the most common (55.1%), followed by E. coli (8.7%). The multivariate analysis indicated that consciousness disorder (odds ratio [OR] = 13.050), peripheral blood C-reactive protein (CRP) >= 50 mg/L (OR = 29.436), and the isolate bacteria being gram-positive bacteria (OR = 8.227) were independent risk factors for predicting who would progress to refractory bacterial meningitis in this group.ConclusionFor patients who have pathogenic positive bacterial meningitis along with consciousness disorder, CRP >= 50 mg/L, and/or have an isolate bacteria that is a G + bacteria, it is important to be alert to the potential for progression to refractory bacterial meningitis, which demands the physicians' significant attention."

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