Ten-year changes in pathogen, antimicrobial susceptibility and clinical feature of children with bacterial meningitis / 中华儿科杂志

<p><b>OBJECTIVE</b>Despite progress in antibiotic therapy and intensive care, childhood bacterial meningitis (BM) remains a devastating disease. We conducted this study to investigate the changes in clinical characteristics, the etiologic agents and antimicrobial susceptibility of BM during the past 10 years in children under 14 years of age.</p><p><b>METHODS</b>These 126 patients were divided into two groups according to their date of admission. Group 1 included 64 patients admitted from January 1998 to December 2002, and group 2 included 62 cases admitted from January 2003 to December 2007. All pediatric medical charts of them were reviewed.</p><p><b>RESULTS</b>The predominant isolated bacteria from CSF were coagulase-negative staphylococcus (17/62, 27.4%) and Escherichia coli (9/62, 14.5%) in group 2. The resistance rate of staphylococcus against oxacillin (MRS) was 68.4% (13/19) in group 2, significantly higher than that of group 1 (16.7%, 2/12). Among 126 cases, 42 had seizure attack and 16 had consciousness disturbance, the proportions of them in group 2 (11/62, 17.7%; 4/62, 6.4%) were lower than those in group 1 (31/64, 48.4%; 12/64, 18.8%, P < 0.05). Cases in group 2 survived with complications [13/62 (21.0%)] and sequelae [11/62 (17.7%)] were lower than those in group 1 (24/64, 37.5%, 23/64, 35.9%, P < 0.05), but the rate of empirical therapy modification in group 2 (21/62, 33.9%) was higher than that in group 1 (7/64, 10.9%, P < 0.01).</p><p><b>CONCLUSION</b>The predominant bacteria in children with BM are staphylococcus and Escherichia coli in recent years. The antibiotic resistance rate of bacteria has been higher year after year. The clinical patterns of pediatric BM have changed with a decrease in clinically serious cases, complications and sequelae, but an increase in modification of empirical therapy.</p>

Clinical study on 27 children with Epstein-Barr virus encephalitis / 实用儿科临床杂志

Objective To explore the clinical characteristics and diagnosis of Epstein-Barr(EB) virus encephalitis(EBE) in children. Methods The verification of EBE was based on detection of EBV DNA in cerebrospinal fluid (CSF) by fluorogenic quantitative PCR(FQ-PCR) and Nest-PCR. The clinical and CSF changes of 27 EBE cases and 26 controls were analyzed and compared. Results EB-DNA in CSF by FQ-PCR of 13 cases of EBE was (2.82?2.03)?10 3copies.There was no significant difference in clinical manifestations between EBE and HSE groups, except that WBC in CSF of EBE was lower than those of HSE.Conclusions EBE is not infrequent, about 10 % of encephalitis in children. EBE is always present independently, which is not a complication of infectious mononucleosis(IM).Detection of EBV-DNA in CSF is a sensitive and specific test for diagnosing of EBE. Early treatment may be beneficial to the prognosis of EBE.