title: [Meningococcal disease admissions in a paediatric intensive care unit].
abstract: BACKGROUND
  Meningococcal infection has a high mortality and morbidity in children. Aggressive initial shock approach, early referral, secondary transport and vaccination are potential factors with impact in reducing its mortality. Objectives were to characterize children admitted to intensive care due to invasive meningococcal disease, to evaluate their prognostic scores and mortality.
  
  
  METHODS
  Observational study, with retrospective data collection. Two periods were created according to the year of admission (A: 2000-2005 and B: 2006-2011). Prognostic parameters, organ failure and mortality rates were compared in these groups.
  
  
  RESULTS
  70 children were admitted with invasive meningococcal disease. When compared with other causes of admission, a decrease in the number of admissions due to invasive meningococcal disease was observed (period A: 3.4%; period B: 1.5%; p = 0.001). The presence of meningitis was 41% in period A and 29% in period B (p = 0.461). Rapidly progressive purpura occurred in 78% in period A and 50% in period B (p = 0.032). Children from period A had multi-organ failure (80%), disseminated intravascular coagulation (76%) and coma (22%) more frequently than children from period B (29%, 29%, 0%; p < 0.05). Mortality was 26% in period A and 0% in period B (p = 0.006) and standardized mortality by PRISM was 1.3 and 0 in period A and B respectively.
  
  
  CONCLUSIONS
  The decrease in the number of admissions due to invasive meningococcal disease can be explained by the introduction of anti-meningococcal C vaccine in 2006. Mortality decline can be possibly explained by an improvement in the initial patient stabilization and to secondary transport.
  
  
  CONCLUSIONS
  A decrease in the number of admissions due to invasive meningococcal disease and in mortality was observed.
authors.affiliation: Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Mação
authors.affiliation: Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Januário
authors.affiliation: Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ferreira
authors.affiliation: Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dias
authors.affiliation: Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Dionísio
authors.affiliation: Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Pinto
authors.affiliation: Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Leonor
authors.initials: L
authors.lastname: Carvalho
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis* / Q000401:mortality*; D010343:Patient Admission; D012189:Retrospective Studies; D012720:Severity of Illness Index