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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1481716

Pediatric bacterial meningitis in southern China: analysis of 838 cases

Provisionally accepted
Lianfeng Chen Lianfeng Chen Wenlin Wu Wenlin Wu Yuanyuan Gao Yuanyuan Gao Xiaojing Li Xiaojing Li Sida Yang Sida Yang Huici Liang Huici Liang Kelu Zheng Kelu Zheng Ya-ni Zhang Ya-ni Zhang Haixia Zhu Haixia Zhu Yang Tian Yang Tian Bingwei Peng Bingwei Peng Haisheng Lin Haisheng Lin Xiuying Wang Xiuying Wang Shuyao Ning Shuyao Ning Yinyan Gan Yinyan Gan Chi Hou Chi Hou Yinting Liao Yinting Liao Huiling Sheng Huiling Sheng Wen-Xiong Chen Wen-Xiong Chen *
  • Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China

The final, formatted version of the article will be published soon.

    Objective: To study the clinical features and risk factors of children with bacterial meningitis (BM) in southern China.Methods: Clinical data of children with BM between 2012 and 2018 from one national center were analyzed retrospectively.Results: 838 patients (male:female=1.8:1) were enrolled with 90.6% under one year old. Common symptoms included fever, seizure, lethargy, vomiting, anorexia, poor feeding, and irritability. Most patients initially exhibited typical cerebrospinal fluid (CSF) changes of BM, including elevated white blood cell count, increased protein levels, and decreased glucose concentration. Some initially atypical cases showed typical changes after about one week. 38.7% of patients had positive bacterial cultures of blood or CSF, with Streptococcus agalactiae, Escherichia coli and Streptococcus pneumoniae commonly seen. 92.0% of patients graded 5 Glasgow outcome scale (GOS) points at discharge. Differences in symptoms, pathogens, CSF results, brain MRI and GOS points were observed across age group (neonate, [29 days, 12 months) and aged ≥12 months). Fatality rate was 1.9%, and 10.7% of survivors had neurological sequelae. Recurrent BM was rare (1.6%), but notable in patients with CSF fistula or immunodeficiency. Risk factors for intensive care unit admission, brain parenchymal involvement, subdural effusion and hearing impairment were identified.Most pediatric BM patients in southern China under one year old with more male distribution and some age-related differences in clinical features and outcomes. Recurrent BM is rare but more likely in patients with conditions such as CSF fistula or immunodeficiency. Most patients have favorable outcomes, with a low fatality rate and around 10% of the survivors experiencing neurological sequelae. Several clinical risk factors clinical were identified.

    Keywords: Bacterial meningitis, Clinical features, Children, prognosis, Risk factors

    Received: 16 Aug 2024; Accepted: 14 Jan 2025.

    Copyright: © 2025 Chen, Wu, Gao, Li, Yang, Liang, Zheng, Zhang, Zhu, Tian, Peng, Lin, Wang, Ning, Gan, Hou, Liao, Sheng and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wen-Xiong Chen, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China

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