Pathogenic and diagnostic analysis of bacterial meningitis children in the Midwest area / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the diagnostic analysis and pathogenic characteristics of bacterial meningitis (BM) in children in Midwest area in China.Methods Clinical and pathogenic data of inpatients with BM were analyzed retrospectively at Xiangya Hospital,Central South University and Children's Hospital of Chongqing Medical University,including age,gender,index of peripheral inflammation,cerebrospinal fluid routine,biochemistry,culture,drug sensitivity and image change.Results In total,446 cases with BM were analyzed in this study.The male-to-female ratios was 1.671.00.Peripheral blood detected abnormal ratios of white blood cell (WBC),C reactive protein(CRP)and procalcitonin (PCT) which were 67.7％ (302/446 cases),64.9％ (268/413 cases) and 71.7％ (279/389 cases),respectively.Cerebrospinal fluid detected abnormal ratios of WBC count,glucose and protein,which were 76.5％ (332/434 cases),71.2％ (306/430 cases) and 91.7 ％ (397/433 cases),respectively;79.4％ of the patients revealed abnormal head CT/MRI image.Bacterial culture positive rate was 33.6％ (150/446 cases),and the positive rates of abnormality in peripheral blood WBC,CRP,PCT or cerebrospinal fluid WBC,glucose and protein were 34.9％ (116/332 cases),34.8％ (138/397 cases),36.6％ (112/306 cases),respectively,which were higher than the normal patients,who were 29.4％ (30/102 cases),25.0％ (9/36 cases),21％ (26/124 cases),respectively.The most common pathogenic bacteria were Streptococcus pneumoniae,Escherichia coli and coagulase negative staphylococcus.Infants within one year presented dominantly with infection of Escherichia coli,accounting for 26.6％ (29/109 cases).Children above 1-year-old presented dominantly with Streptococcus pneumoniae,accounting for 61.0％ (25/41 cases).A drug-resistance phenomenon was common among pathogenic bacteria.Conclusion Abnormality in peripheral blood WBC,CRP,PCT or cerebrospinal fluid WBC,glucose and protein,and subdural effusion/empyema can help the early diagnosis and differential diagnosis of BM.The most common pathogenic bacteria in Midwest area of China are Streptococcus pneumoniae,Escherichia coli and coagulase negative staphylococcus,which suggests recommend the application of Streptococcus pneumoniae vaccine.Drug-resistance phenomenon to pathogens is very common.For the treatment strategy,it should be made and adjusted timely according to the drug sensitivity and common hospital antimicrobial spectrum.