Predicting Outcome of Childhood Bacterial Meningitis With a Single Measurement of C-Reactive Protein

Peltola, Heikki; Pelkonen, Tuula; Roine, Irmeli; Cruzeiro, Manuel Leite; Bernardino, Luís

doi:10.1097/inf.0000000000001133

Cited by 8 publications

(2 citation statements)

References 19 publications

(32 reference statements)

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“…Peng et al [ 9 ] found that unequal pupils and CSF glucose < 1.5 mmol/L are high risk factors for poor prognosis of refractory bacterial meningitis, but there is a lack of further analysis of factors associated with pathogenic positive bacterial meningitis. Based on our previous research and clinical experience, we selected 23 factors related to refractory outcome or poor prognosis for statistical analysis [ 30 – 32 ] and found that early-stage consciousness disorder, CRP ≥ 50 mg/L, and the isolate bacteria being G + bacteria were independent risk factors for pathogenic positive bacterial meningitis cases to progress to refractory outcomes.…”

Section: Discussionmentioning

confidence: 99%

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High-risk factors associated with refractory childhood bacterial meningitis in Southwest China

Song

et al. 2023

BMC Pediatr

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Background Refractory bacterial meningitis is acute, develops rapidly, and has higher mortality and morbidity than common bacterial meningitis. This study was undertaken to investigate the high-risk factors related to refractory bacterial meningitis in children with positive pathogens. Methods We retrospectively analyzed the clinical data of 109 patients who had bacterial meningitis. The patients were divided into a refractory group (96 patients) and nonrefractory group (13 patients) based on the classification criteria. Seventeen clinical variables on risk factors were extracted and evaluated by univariate and multivariate logistic regression analyses. Results There were 64 males and 45 females. The onset age ranged from 1 month old to 12 years old, and the median age was 181 days old. The pathogenic bacteria included 67 cases of gram-positive (G+) bacteria (61.5%) and 42 cases of gram-negative (G-) bacteria. In patients who were 1 to 3 months old, E. coli was the most common (47.5%), followed by Streptococcus agalactiae and Staphylococcus hemolyticus (10.0%); in patients > 3 months old, S. pneumoniae was the most common (55.1%), followed by E. coli (8.7%). The multivariate analysis indicated that consciousness disorder (odds ratio [OR] = 13.050), peripheral blood C-reactive protein (CRP) ≥ 50 mg/L (OR = 29.436), and the isolate bacteria being gram-positive bacteria (OR = 8.227) were independent risk factors for predicting who would progress to refractory bacterial meningitis in this group. Conclusion For patients who have pathogenic positive bacterial meningitis along with consciousness disorder, CRP ≥ 50 mg/L, and/or have an isolate bacteria that is a G + bacteria, it is important to be alert to the potential for progression to refractory bacterial meningitis, which demands the physicians’ significant attention.

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Section: Discussionmentioning

confidence: 99%

“…The increase in the CRP value reflects the severity of the infection [ 30 ]. Similarly, the CRP value can also help predict the prognosis and outcome [ 6 , 25 , 32 ]. Liu Yuming et al [ 34 ] believed that CRP > 100 mg/L is indicative of a poor prognosis for children with pneumococcal meningitis.…”

Section: Discussionmentioning

confidence: 99%