[Multicenter prospective study on severe bacterial meningitis in children].
We prospectively studied the epidemiologic, clinic signs and outcome of bacterial meningitis in 125 children who were admitted into a PICU (Pediatric Intensive Care Unit) of 11 hospitals of Spain and whose meningitis was diagnosed between May 1994 and April 1995.


RESULTS
The median age of the children was 3.55 +/- 3.32 years (range 1 month to 16.5 yrs). Eighty-eight were bacterial meningitis, probably bacterial 30 and aseptic 7. The most frequently isolated organisms were N. meningitidis (52), H. influenza type b (17) and S. pneumoniae (8). Twenty-five percent of N. meningitidis had C serotype. Incidence rate of each germen was depending of age. All patients diagnosed of H. influenza type b meningitis were less than 3 years old. H. influenza type b and meningococcus had similar incidence rate during the first year of life (27% versus 31%). During the first three years of life H. influenza type b produced one third of bacterial meningitis. A mortality rate of 5.6% (seven patients: 3 S. pneumoniae, 1 N. meningitidis, 1 H. influenza type b and 2 unknown germen) was observed. Patients who die had lower Glasgow coma score (p = 0.034) and seizures (p = 0.001) at admission. At discharge of PICU, 9 survivors (7.2%) had sequelae: mental retardation in 7 patients and hearing loss in two. One third of patients needed hemodynamic support and a 15% of them ventilatory support.


CONCLUSIONS
Age is an important epidemiological factor in the etiology of pediatric acute meningitis. H. influenza type b and N. meningitidis had similar incidence rate during the first year of life. S. pneumoniae had the highest mortality rate (37.5%). The presence of coma and seizures at admission were associated with mortality.
Casado Flores
J
J
Grupo Colaborativo para el Estudio de las Infecciones del SNC en UCI Pediátrica, Hospital Infantil Niño Jesús, Madrid.
García Teresa
M A
MA
Cambra
F
F
Pilar Orive
J
J
Teja
J L
JL
Rodríguez Núñez
A
A
Quiroga
E
E
Calvo
C
C
Ruiz Extremera
M A
MA
Pérez Navero
J
J
Melendo
J
J
Soult
J A
JA
D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000453:epidemiology*; D011446:Prospective Studies; D012720:Severity of Illness Index
Estudio prospectivo multicéntrico de la meningitis bacteriana grave pediátrica.