A Multicenter Epidemiological and Pathogenic Characteristics Study of Community-Acquired Bacterial Meningitis Children in China: Results from the Chinese Pediatric Bacterial Meningitis Surveillance (CPBMS) 2019-2020

作者全名："Wang, Caiyun; Xu, Hongmei; Liu, Gang; Liu, Jing; Yu, Hui; Chen, Biquan; Zheng, Guo; Shu, Min; Du, Lijun; Xu, Zhiwei; Huang, Lisu; Li, Haibo; Shu, Sainan; Chen, Yinghu"

作者地址："[Wang, Caiyun; Huang, Lisu; Chen, Yinghu] Zhejiang Univ, Childrens Hosp, Dept Infect Dis, Natl Childrens Reg Med Ctr,Sch Med, Hangzhou, Zhejiang, Peoples R China; [Xu, Hongmei] Childrens Hosp Chongqing Med Univ, Dept Infect Dis, Chongqing, Peoples R China; [Liu, Gang] Capital Med Univ, Beijing Childrens Hosp, Dept Infect Dis,Natl Ctr Childrens Hlth, Key Lab Major Dis Children,Minist Educ, Beijing, Peoples R China; [Liu, Gang] Chinese Acad Med Sci, Res Unit Crit Infect Children, Beijing, Peoples R China; [Liu, Jing] Hunan Childrens Hosp, Dept Infect Dis, Changsha, Hunan, Peoples R China; [Yu, Hui] Fudan Univ, Childrens Hosp, Dept Infect Dis, Shanghai, Peoples R China; [Chen, Biquan] Anhui Prov Childrens Hosp, Dept Infect, Hefei, Anhui, Peoples R China; [Zheng, Guo] Nanjing Med Univ, Dept Neurol, Childrens Hosp, Nanjing, Jiangsu, Peoples R China; [Shu, Min] Sichuan Univ, West China Univ Hosp 2, Dept Pediat, West China Womens & Childrens Hosp, Chengdu, Peoples R China; [Du, Lijun] Childrens Hosp Shanxi, Dept Neurol, Taiyuan, Shanxi, Peoples R China; [Xu, Zhiwei] Wenzhou Med Univ, Affiliated Hosp 2, Pediat Inpatient Ward, Wenzhou, Zhejiang, Peoples R China; [Xu, Zhiwei] Wenzhou Med Univ, Yuying Childrens Hosp, Wenzhou, Zhejiang, Peoples R China; [Huang, Lisu] Shanghai Jiao Tong Univ, Sch Med, Xinhua Hosp, Dept Infect Dis, Shanghai, Peoples R China; [Li, Haibo] First Hosp Jilin Univ, Outpatient Dept Pediat, Changchun, Jilin, Peoples R China; [Shu, Sainan] Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Pediat Infect & Gastroenterol, Wuhan, Hubei, Peoples R China"

通信作者："Chen, YH (通讯作者)，Zhejiang Univ, Sch Med, Natl Clin Res Ctr Child Hlth,Childrens Hosp, Natl Childrens Reg Med Ctr,Dept Infect Dis, 3333 Binsheng Rd, Hangzhou 310052, Zhejiang, Peoples R China."

来源：INFECTION AND DRUG RESISTANCE

ESI学科分类：IMMUNOLOGY

WOS号：WOS:001085122400001

JCR分区：Q2

影响因子：2.9

年份：2023

卷号：16

期号：　

开始页：6587

结束页：6601

文献类型：Article

关键词：meningitis; bacterial; pathogen; childhood; diagnosis; outcome

摘要："Objective: To explore the epidemiological and pathogenic characteristics of children with community-acquired bacterial meningitis. Methods: A multicenter, retrospective study was conducted among CABM patients under 15 years old from 33 hospitals in China from 2019 to 2020. The medical record, laboratory, and microbiological data were collected and analyzed. Results: A total of 1610 children with CABM were identified and presented at a median onset age of 45 days of whom 955 (59.3%) were males. CABM occurred mostly in infants 1 year of age (84.0%, 1352/1610). In etiology-confirmed cases, the pathogens were isolated from CSF culture in 515 (32.0%), 400 (24.8%) in blood culture, and 186 (11.6%) both in CSF and blood culture. In total, 126 pathogens were identified through CSF mNGS in 330 CABM cases; 21 S. pneumoniae isolates were detected in 83 CABM cases by antigen detection method. Major pathogens were E. coli (195, 24.7%), GBS (170, 21.5%), and S. pneumoniae (157, 19.9%). GBS (29.3%, 22/75) was the first pathogen of CABM in neonates aged 0-6 days old, while E. coli (44.7%, 76/170) in 7 to 28 days of age; S. pneumoniae (96.2%, 151/157) was the most common pathogen in 3 months old cases. About 9.7% (19/195) strains of E. coli produced ultra-broad-spectrum beta -lactamases. The common intracranial imaging complications were subdural effusion and (or) empyema in 349 (21.7%), hydrocephalus in 233 (14.5%), and cerebral abscess in 178 (11.1%). A total of 389 (24.2%) cases were completely cured and 1088 (67.6%) cases improved. Among 166 patients (10.3%) with adverse outcomes, 32 cases (2.0%) died, and 37 cases (2.3%) relapsed. Conclusion: The onset age of CABM in children is usually within 1 year of age, especially <3 months. The primary pathogens in infants less than 3 months old are E. coli and GBS, and the dominant pathogen in children older than 3 months old is S. pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. CABM should not be excluded even if CSF leukocyte counts are within normal range. Due to the low detection rate of pathogens in children with CABM, standardized CSF bacteriological examination should be paid more attention to increase the pathogen detection rate. Non-culture CSF detection methods may facilitate pathogenic diagnosis."

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