Single center study on the distribution and pathogen changes of purulent meningitis in children during past 20 years / 中华实用儿科临床杂志

ABSTRACT

Objective To study the distribution and changes of the purulent meningitis in gender,age,region,season and pathogens in children during the past 20 years.Methods All the basic clirical features of purulent meningitis patients less than 17 years old in Children's Hospital of Chongqing Medical University from Jan.1993 to Jan.2013 were analyzed retrospectively.A total of 1 855 patients were divided into 2 groups according to their date of admission.Group A included 666 patients admitted from Jan.1993 to Dec.2002,and group B included 1 189 cases admitted from Jan.2003 to Jan.2013.Then,they were divided into 5 groups according to their ages,including neonate group,＞ 1 month-1 year old aoup,＞ 1-3 years old group,＞ 3-10 years old group,＞ 10-17 years old group.Results Of the 1 855 cases,there were 1 054 cases (56.82％) admitted in the spring and summer,and 1 123 cases (60.54％) were younger than 1 year of age.The ratio of male to female cases was 1.82 to 1.00 and that of country patients to urban patients was 1.40 to 1.00.The distributions were female patients (443 cases,37.26％),urban patients (517 cases,43.48％),and the ratio of patients admitted in the autumn (265 cases,22.29％) and patients younger than 1 year of age (606 cases,50.97％) in group B,which were significantly higher than those [215 cases (32.28％),256 cases (38.44％),102 cases (15.32％),272 cases (40.84％)] of group A (x2 =4.62,4.47,25.51,25.52,all P ＜ 0.05).The predominant isolated bacteria from cerebrospinal fluid were coagulase negative staphylococcus (43/196 cases,21.94％),Streptococcus pneumoniae (32/196 cases,16.33％),Neisseria meningitidis (17/196 cases,8.67％) and Escherichia coli (15/196 cases,7.65％).Coagulase negative staphylococcus and Escherichia coli both accounted for higher rates of pathogenic bacteria in 1 year old than that of pathogenic bacteria more than 1 year old (x2 =4.57,14.37,all P ＜ 0.05),while Streptococcus pneumoniae and Neisseria meningitidis both had higher rates of pathogenic bacteria more than 1 year old and more than 3 years old,respectively (x2 =14.93,19.76,all P ＜ 0.05).Onfly cases in group B with Streptococcus pneumoniae were higher than those in group A (x2 =11.78,P ＜ 0.05),while the other common bacteria in each age group were of no difference between group A and group B.Conclusions There had been some changes in the epidemiological distribution of purulent meningitis during the past 20 years.The main risk factors were male in gender,patients in rural areas,onset in the spring or summer and infants in early age.The predominant isolated bacteria from cerebrospinal fluid were some opportunistic pathogens,including coagulase negative staphylococcus,Streptococcus pneumoniae,and Escherichia coli.Streptococcus pneumoniae meningitis was increased during the past 10 years.