Clinical characteristics and etiology of bacterial meningitis in Chinese children >28 days of age, January 2014-December 2016: A multicenter retrospective study

Int J Infect Dis. 2018 Sep;74:47-53. doi: 10.1016/j.ijid.2018.06.023. Epub 2018 Jul 6.

Abstract

Objective: To explore the clinical characteristics and etiology of bacterial meningitis (BM) in Chinese children.

Method: BM cases in children 28days to 18 years old were collected from January 2014-December 2016 and screened according to World Health Organization standards. Clinical features, pathogens, and resistance patterns were analyzed.

Results: Overall, 837 cases were classified into five age groups: 28 days-2 months (17.0%), 3-11 months (27.8%), 12-35 months (24.0%), 3-6 years (13.9%), and >6years (17.3%). Major pathogens were Streptococcus pneumoniae (S. pneumoniae, n=136, 46.9%), group B Streptococcus (GBS, n=29, 10.0%), and Escherichia coli (E. coli, n=23, 7.9%). In infants <3 months old, GBS (46.5%) and E. coli (23.3%) were most common; in children >3 months old, S. pneumoniae (54.7%), which had a penicillin non-susceptibility rate of 55.4% (36/65), was most frequent. The resistance rates of S. pneumoniae and E. coli to cefotaxime and ceftriaxone were 14.0%/40.0% and 11.3%/68.4%, respectively. All GBS isolates were sensitive to penicillin.

Conclusions: The occurrence of BM peaked in the first year of life, while S. pneumoniae was the predominant pathogen in children >3months of old. The antibiotic resistance of S. pneumoniae was a concern.

Keywords: Antibiotic susceptibility; Bacterial meningitis; Children; Pathogen.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / pharmacology
  • Cefotaxime / pharmacology
  • Ceftriaxone / pharmacology
  • Child
  • Child, Preschool
  • China / epidemiology
  • Drug Resistance, Bacterial
  • Escherichia coli / drug effects
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification*
  • Escherichia coli / physiology
  • Female
  • Humans
  • Infant
  • Male
  • Meningitis, Bacterial / drug therapy
  • Meningitis, Bacterial / epidemiology
  • Meningitis, Bacterial / microbiology*
  • Microbial Sensitivity Tests
  • Penicillin G / pharmacology
  • Retrospective Studies
  • Streptococcus agalactiae / drug effects
  • Streptococcus agalactiae / genetics
  • Streptococcus agalactiae / isolation & purification*
  • Streptococcus agalactiae / physiology
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / genetics
  • Streptococcus pneumoniae / isolation & purification*
  • Streptococcus pneumoniae / physiology

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Cefotaxime
  • Penicillin G