Childhood meningitis in the conjugate vaccine era: a prospective cohort study

被引：34

作者：

Sadarangani, Manish ^{[1
,2
]}

Willis, Louise ^{[1
,2
]}

Kadambari, Seilesh ^{[3
]}

Gormley, Stuart ^{[4
]}

Young, Zoe ^{[1
,2
]}

Beckley, Rebecca ^{[1
,2
]}

Gantlett, Katherine ^{[1
,2
]}

Orf, Katharine ^{[5
]}

Blakey, Sarah ^{[5
]}

Martin, Natalie G. ^{[1
,2
]}

Kelly, Dominic F. ^{[1
,2
]}

Heath, Paul T. ^{[3
]}

Nadel, Simon ^{[4
]}

Pollard, Andrew J. ^{[1
,2
]}

机构：

[1] Univ Oxford, Dept Paediat, Oxford OX3 9DU, England

[2] John Radcliffe Hosp, NIHR Oxford Biomed Res Ctr, Oxford OX3 9DU, England

[3] Univ London, Inst Infect & Immun, Paediat Infect Dis Res Grp, London, England

[4] St Marys Hosp, Dept Paediat, London, England

[5] Univ Oxford, Sch Med, John Radcliffe Hosp, Oxford OX3 9DU, England

来源：

ARCHIVES OF DISEASE IN CHILDHOOD | 2015年 / 100卷 / 03期

关键词：

CLINICAL DECISION RULES; ASEPTIC-MENINGITIS; BACTERIAL; CHILDREN;

D O I：

10.1136/archdischild-2014-306813

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Bacterial conjugate vaccines have dramatically changed the epidemiology of childhood meningitis; viral causes are increasingly predominant, but the current UK epidemiology is unknown. This prospective study recruited children under 16 years of age admitted to 3 UK hospitals with suspected meningitis. 70/388 children had meningitis-13 bacterial, 26 viral and 29 with no pathogen identified. Group B Streptococcus was the most common bacterial pathogen. Infants under 3 months of age with bacterial meningitis were more likely to have a reduced Glasgow Coma Score and respiratory distress than those with viral meningitis or other infections. There were no discriminatory clinical features in older children. Cerebrospinal fluid (CSF) white blood cell count and plasma C-reactive protein at all ages, and CSF protein in infants <3 months of age, distinguished between bacterial meningitis and viral meningitis or other infections. Improved diagnosis of non-bacterial meningitis is urgently needed to reduce antibiotic use and hospital stay.

引用

页码：292 / 294

页数：3

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