Clinical features of childhood purulent meningitis caused by Escherichia coli and Streptococcus pneumoniae: a comparative analysis
HAN Wei, JIANG Li, MA Jian-Nan, SONG Xiao-Jie, HE Rong
Department of Neurology, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
Abstract：Objective To investigate the differences in clinical features of childhood purulent meningitis (PM) caused by Escherichia coli and Streptococcus pneumoniae, and to provide help for the selection of antibiotics for PM children with unknown etiology. Methods A retrospective analysis was performed for the clinical data of children with PM caused by Escherichia coli (12 children) or Streptococcus pneumoniae (15 children). Results Compared with the Streptococcus pneumoniae infection group, the Escherichia coli infection group had a significantly higher proportion of children with an age of onset of 39°C) and disturbance of consciousness and a significantly lower proportion of children with an increased leukocyte count at diagnosis (>12×109/L). The results of routine cerebrospinal fluid test and biochemical examinations showed no significant differences between the two groups. Escherichia coli and Streptococcus pneumoniae were resistant to cephalosporins and had a sensitivity to chloramphenicol more than 90%. Escherichia coli was fully sensitive to meropenem and Streptococcus pneumoniae was fully sensitive to vancomycin. Conclusions PM caused by Escherichia coli and Streptococcus pneumoniae has different clinical features. As for PM children with severe fever, disturbance of consciousness, and an increased leukocyte count, the probability of Streptococcus pneumoniae infection should be considered. For PM children with an age of onset of Escherichia coli infection should be considered.
HAN Wei,JIANG Li,MA Jian-Nan et al. Clinical features of childhood purulent meningitis caused by Escherichia coli and Streptococcus pneumoniae: a comparative analysis[J]. CJCP, 2016, 18(7): 573-576.
Amarilyo G, Alper A, Ben-Tov A, et al. Diagnostic accuracy of clinical symptoms and signs in children with meningitis[J]. Pediatr Emerg Care, 2011, 27(3): 196-199.
[2]
Thaver D, Zaidi AK. Burden of neonatal infections in developing countries: a review of evidence from communitybased studies[J]. Pediatr Infect Dis J, 2009, 28(1 Suppl): S3-S9.
[3]
Molyneux E, Riordan FA, Walsh A. Acute bacterial meningitis in children presenting to the Royal Liverpool Children's Hospital, Liverpool, UK and the Queen Elizabeth Central Hospital in Blantyre, Malawi: a world of difference[J]. Ann Trop Paediatr, 2006, 26(1): 29-37.
Brauteset LV, Høiby EA, Syversen G, et al. Invasive pneumoccal disease in children in Oslo 1998-2004[J]. Tidsskr Nor Laegeforen, 2008, 128 (12): 1380-1383.
Braun V, Eskens U, Hartmann A, et al. Focal bacterial meningitis following ascending bite wound infection leading to paraparesis in a captive California sea lion (Zalophus californianus)[J]. J Zoo Wildl Med, 2015, 46(1): 135-140.
[10]
Lynch JP, Zhanel GG. Streptococcus pneumoniae: epidemiology and risk factors, evolution of antimicrobial resistance, and impact of vaccines[J]. Curr Opin Pulm Med, 2010, 16(3): 217- 225.
[11]
Cardozo DM, Nascimento-Carvalho CM, Andrade AL, et al. Prevalence and risk factors for nasopharyngeal carriage of Streptococcus pneumoniae among adolescents[J]. J Med Microbiol, 2008, 57(Pt 2): 185-189.
Tsumura R, Ikawa K, Morikawa N, et al. The pharmacokinetics and pharmacodynamics of meropenem in the cerebrospinal fluid of neurosurgical patients[J]. J Chemother, 2008, 20(5): 615-621.
[14]
Kim KS. Acute bacterial meningitis in infants and children[J]. Lancet Infect Dis, 2010, 10(1): 32-42.
