title: The burden of pneumococcal meningitis in Austrian children between 2001 and 2008.
abstract: The present study was conducted to evaluate the burden of pneumococcal meningitis in Austrian children between 2001 and 2008. Clinical outcome was retrospectively analyzed both on discharge and on follow-up investigations. This study was based on a prospective multicentre surveillance study on hospitalized invasive pneumococcal infections in Austrian children with a total annual "study population" of about 399,000 children aged below 5 years per year. Between 2001 and 2008, 74 cases of pneumococcal meningitis were identified in children aged below 5 years. The mean annual incidence rate for pneumococcal meningitis was 2.3 per 100,000 children in this age group. In 57/74 children (mean age on admission 14.5 ± 13.3 months), outcome data on hospital discharge were available: 5 deaths (8.8%), 20 children (35.1%) with sequelae and 32 children (56.1%) without sequelae were observed. Sequelae on discharge included motor impairment in 8 children (14.0%), hearing impairment in 9 children (15.8%) and/or other complications in 14 children (24.6%). In 7/8 children with motor deficits, matching cerebral lesions were identified by neuroimaging: cerebral infarction in five children, cerebral vasculitis and cerebral abscess in one child each. In 40/57 children, long-term outcome (18.9 ± 20.2 months after discharge) could be assessed: 1 child (2.5%) died 9 months after hospital discharge, 11 children (27.5%) had one or two long-term sequelae and 28 children (70.0%) had no sequelae. Long-term sequelae included motor impairment in three children (7.5%), hearing impairment in nine children (22.5%) and other deficits in two children (5.0%).
  
  
  CONCLUSIONS
  Our study confirms that pneumococcal meningitis causes high mortality and severe long-term sequelae. On long-term follow-up, we observed improvements of motor impairment, but not of hearing impairment.
authors.affiliation: Department of General Paediatrics, University Clinic of Paediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria.
authors.forename: D S
authors.initials: DS
authors.lastname: Klobassa
authors.forename: B
authors.initials: B
authors.lastname: Zoehrer
authors.forename: M
authors.initials: M
authors.lastname: Paulke-Korinek
authors.forename: U
authors.initials: U
authors.lastname: Gruber-Sedlmayr
authors.forename: K
authors.initials: K
authors.lastname: Pfurtscheller
authors.forename: V
authors.initials: V
authors.lastname: Strenger
authors.forename: A
authors.initials: A
authors.lastname: Sonnleitner
authors.forename: R
authors.initials: R
authors.lastname: Kerbl
authors.forename: B
authors.initials: B
authors.lastname: Ausserer
authors.forename: W
authors.initials: W
authors.lastname: Arocker
authors.forename: W
authors.initials: W
authors.lastname: Kaulfersch
authors.forename: B
authors.initials: B
authors.lastname: Hausberger
authors.forename: B
authors.initials: B
authors.lastname: Covi
authors.forename: F
authors.initials: F
authors.lastname: Eitelberger
authors.forename: A
authors.initials: A
authors.lastname: Vécsei
authors.forename: B
authors.initials: B
authors.lastname: Simma
authors.forename: R
authors.initials: R
authors.lastname: Birnbacher
authors.forename: H
authors.initials: H
authors.lastname: Kurz
authors.forename: K
authors.initials: K
authors.lastname: Zwiauer
authors.forename: D
authors.initials: D
authors.lastname: Weghuber
authors.forename: S
authors.initials: S
authors.lastname: Heuberger
authors.forename: F
authors.initials: F
authors.lastname: Quehenberger
authors.forename: H
authors.initials: H
authors.lastname: Kollaritsch
authors.forename: W
authors.initials: W
authors.lastname: Zenz
mesh_terms: D000293:Adolescent; D001317:Austria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*