Predisposing Conditions and Etiology of Pediatric Recurrent Bacterial Meningitis in Beijing Children's Hospital, 2006-2018

Abstract

Objective To investigate the predisposing conditions, etiology and clinical characteristics of recurrent bacterial meningitis (RBM) in children.Methods Seventy patients of RBM treated in Beijing Children's Hospital from January 2006 through December 2018 were retrospectively analyzed.Results Predisposing conditions of RBM include: inner ear malformations 24(34.3%), dermal sinus tracts 15(21.4%), head trauma 15(21.4%), meningoencephalocele 12(17.1%), and immune deficiency 4(5.7%). Sixty-seven occasions of meningitis had positive bacterial cultures. Thirty-one occasions of Streptococcus pneumoniae ( S. pneumonia ) meningitis and 3 occasions of Haemophilus influenzae type b (Hib) meningitis occurred in the 24 patients with inner ear malformations; Seventeen occasions of S. pneumonia meningitis occurred in the 15 patients with head trauma, while 8 occasions of S. pneumonia meningitis in 12 patients with Meningoencephalocele; There were 2 Enterococcus faecalis meningitis, 1 Escherichia coli meningitis and 1 Staphylococcus aureus meningitis in 15 patients with dermal sinus tracts; Two of 4 patients with immune deficiency suffered S. pneumoniae meningitis.Conclusions Predisposing conditions of RBM in children include inner ear malformations, head trauma, meningoencephalocele, dermal sinus tracts, and immune deficiency. The most common etiology of RBM with inner ear malformation, head trauma, meningoencephalocele, and immune deficiency is S. pneumoniae . Empiric antibiotic treatment of RBM in children should cover S. pneumoniae.