Toczylowski Kacper, Bojkiewicz Ewa, Barszcz Marta, Wozinska-Klepadlo Marta, Potocka Paulina, Sulik Artur
Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland.
J Clin Med. 2020 Jul 22;9(8):2324. doi: 10.3390/jcm9082324.
Little is known about the causes and the frequency of meningitis and encephalitis in Poland. We did a retrospective single-center cohort study of children under 18 years old hospitalized with infectious meningitis or encephalitis. Incidence rates were calculated using collected data from patients from the North-East Poland only. A total of 374 children hospitalized between 1 January 2015 and 31 December 2019 were included in the study. A total of 332 (89%) children had meningitis, and 42 (11%) had encephalitis. The etiology of the infection was established in 331 (89%) cases. Enteroviruses accounted for 224 (60%) of all patients. A total of 68 (18%) cases were tick-borne infections. Bacterial pathogens were detected in 26 (7%) children. The median length of hospital stay for children with enteroviral meningitis was 7 days (IQR 7-9), increasing to 11 days (8-13) in those treated with antibiotics. The incidence of meningitis was estimated to be 32.22 (95% CI, 25.33-40.98) per 100,000 and that of encephalitis to be 4.08 (95% CI, 2.07-8.02) per 100,000. By the broad use of molecular diagnostic methods, we managed to identify etiology of the infection in the majority of children. Our data suggest that thorough diagnostics of central nervous system infections are needed to rationalize treatment.
在波兰,人们对脑膜炎和脑炎的病因及发病频率了解甚少。我们对18岁以下因感染性脑膜炎或脑炎住院的儿童进行了一项回顾性单中心队列研究。发病率是仅使用从波兰东北部患者收集的数据计算得出的。2015年1月1日至2019年12月31日期间共有374名住院儿童纳入研究。共有332名(89%)儿童患有脑膜炎,42名(11%)患有脑炎。331例(89%)病例确定了感染病因。肠道病毒占所有患者的224例(60%)。共有68例(18%)为蜱传感染。26名(7%)儿童检测到细菌病原体。肠道病毒性脑膜炎患儿的中位住院时间为7天(四分位间距7 - 9天),接受抗生素治疗的患儿住院时间增至11天(8 - 13天)。脑膜炎的发病率估计为每10万人32.22例(95%置信区间,25.33 - 40.98),脑炎的发病率为每10万人4.08例(95%置信区间,2.07 - 8.02)。通过广泛使用分子诊断方法,我们成功确定了大多数儿童感染的病因。我们的数据表明,需要对中枢神经系统感染进行全面诊断以使治疗合理化。