Clinical data in children with meningococcal meningitis in a Spanish hospital

Acta Paediatr. 1997 Jan;86(1):26-9. doi: 10.1111/j.1651-2227.1997.tb08826.x.

Abstract

Neisseria meningitidis is the main cause of bacterial meningitis in Spain. Of the 213 children included in this study with meningococcal meningitis, 7 died. Mortality was linked to a shorter time from the first symptom to diagnosis (mean time for fatal cases was 9.5 h, mean time for survivors was 19 h, p = 0.034), to deteriorated consciousness (DC) (mortality rate (MR) with DC = 6/87, MR without DC = 1/124, p = 0.02) and to shock (MR with shock = 5/7, MR without shock = 2/206, p < 0.0001). Previous treatment reduced the yield from blood culture (36/54 versus 45/137, p < 0.0001). Positivity in both Gram stain (GS) and cerebrospinal fluid (CSF) culture increased with longer duration of symptoms (mean GS+ = 25 h, GS- = 16 h, p = 0.004; CSF+ = 20 h, CSF- = 12 h, p = 0.001), and blood culture (BC) gave more positive results when carried out earlier (mean BC- = 14 h, BC- = 24 h, p < 0.001). Reduced susceptibility to penicillin was seen in 34% of the strains, and rapidly evolving forms were responsible for most of the deaths; reduced susceptibility was more frequent among strains responsible for death or sequelae (9/15 = 60%) as compared with the more harmless strains (69/ 215 = 32%) (p = 0.04). The progressive reduction of susceptibility to penicillin indicates that it should be replaced by a third-generation cephalosporine.

MeSH terms

  • Adolescent
  • Age Distribution
  • Child
  • Child, Preschool
  • Female
  • Hospital Mortality
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Meningitis, Meningococcal* / complications
  • Meningitis, Meningococcal* / diagnosis
  • Meningitis, Meningococcal* / microbiology
  • Meningitis, Meningococcal* / mortality
  • Microbial Sensitivity Tests
  • Penicillin Resistance
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Spain
  • Time Factors