CLINICAL FEATURES AND COMPLICATIONS OF BACTERIAL MENINGITIS IN CHILDREN
Relevance: Bacterial meningitis (BM) remains a significant cause of neurological complications and high mortality among children.
Aim: to study the clinical features of BM in children to optimize the diagnosis and etiopathogenetic therapy.
Methods: The object of the study is children diagnosed with meningitis, treated at the Multidisciplinary City Children's Hospital No. 3 in Astana, for the period from 2015 to 2023. Study design: prospective, control - case. Methods included clinical examination, complete blood count, cerebrospinal fluid test, CT and brain MRI. Descriptive statistics and Pearson's method were used for statistical processing.
Results: Introduction of the PCV13 vaccine led to a fourfold decrease in the incidence of pneumococcal meningitis, while cases of meningococcal meningitis declined 1.6 times from 2014 to 2023. The main clinical manifestations in children with BM included high fever (80–90% of patients, with febrile temperatures ranging from 38.7°C to 39.9°C), neurological deficits, and complications: seizures and cognitive impairment developed in 50% of children. Hypertensive syndrome was observed in 81.8% of children with pneumococcal meningitis (PM), and in 55.6% of meningococcal meningitis (MM) cases among children under one year old. Pneumococcal CNS involvement was characterized by focal symptoms in 45.5% of young children, while such changes were statistically significantly lower in MM cases—threefold less (16.7%, p≤0.001). Spearman’s correlation analysis in the PM group showed a strong direct positive relationship between the following variables: delayed medical consultation and hospital stay duration (r=0.7; p≤0.001), delayed diagnosis and hospital stay duration (r=0.7; p≤0.001).
Conclusion: PCV13 vaccination has significantly reduced the incidence of pneumococcal meningitis, which presents most severely, with early neurological complications in 41.5% of cases, cerebral edema in 90.9% of infants, and hypertensive syndrome in 81.8%. Early diagnosis and timely treatment contribute to the prevention of both early and late neurological complications.
Baesheva Dinagul - MD, MD, Head of the Department of Pediatric Infectious Diseases, "Astana Medical University", postal address: 014692/Z05P6T4 Astana, M.Dulatov str. 17, Phone: +7 701 380 60 10 E-mail: baesheva_dina@mail.ru , https://orcid.org/0000-0002-1141-1564 – development of research methodology, formulation of conclusions.
Zhumagalieva Galina - Professor of the Department of Pediatric Infectious Diseases, Candidate of Medical Sciences, NAO "Astana Medical University", Phone: +7 707 825 89 77 Postal address: 010000, Astana, Najvedenova str., 13, sq. 105. galdau@mail.ru , https://orcid.org/0000-0002-5448-072X – critical revision of the text of the manuscript, editing of the text of the manuscript.
Kosherova Bakhyt - Doctor of Medical Sciences, Professor of the Department of Pediatric Infectious Diseases, NAO"Astana Medical University", Astana, postal address: 010000 Astana, Alikhan Bukeikhan 29, 66, Phone: +7 701 147 25 03, E-mail: bakosherova@mail.ru , https://orcid.org / 0000-0001-8238-5255 – statistical analysis data, generalization of the research results, formulation of conclusions.
Turdalina Bayan - MD, PhD, Associate Professor of the Department of Pediatric Infectious Diseases of the NAO "Astana Medical University", doctor on duty at Multidisciplinary City Children's Hospital No. 3, postal address: 010000 Astana, Al-Farabi ave., d-1, 96, Phone: +7 74) 268 66 32 E-mail: turdalina777bayan@gmail.com, https://orcid.org/0000-0002-3955-4903 collection of biomaterial of the main group statistical data analysis.
Altynbekova Alyona - MD, Assistant of the Department of Pediatric Infectious Diseases of the National Academy of Sciences "Astana Medical University", infectious diseases specialist, Astana City Polyclinic No. 6, postal address: Akmola region, Arshaly district, A.Zhibek Zholy, Kazybek bi str. 62B, Phone: +7 701 689 30 13 , E-mail: alena_88.08@mail.ru , https://orcid.org/0000-0002-4407-4525 – editing the text of the manuscript, making the manuscript, working with graphic material. The author is a correspondent.
Kubekova Saule - MD, PhD, Associate Research Professor at the Department of Internal Medicine with a course in Geriatrics, NAO "Astana Medical University", cardiologist at the MC MediHealth Medical Center postal address: 010000 Astana, Koshkarbayeva 10, 2009, Phone: +7 701 523 00 36 , E-mail: dr.kubekova@gmail.com, https://orcid.org/0000-0001-5358-3690 – data collection and systematization.
Zhuzzhasarova Aigerim - MD, PhD, Associate Professor of the Department of Infectious Diseases and Dermatovenerology, South Kazakhstan Medical Academy, Shymkent, postal address: 16005 Shymkent, district Nursat 158,KV 37, Phone: +7 708 999 48 89 , E-mail: zhuzzhasarova.a87@gmail.com, https://orcid.org/0000-0001-6556-4489 – collecting the biomaterial of the control group and statistical data analysis.
Utegenova Aigul - PhD, Associate Professor of the Department of Microbiology and Virology named after Sh. I. Sarbasova NAO "Medical University of Astana," postal address: 010000, Astana, Kabanbai Batyr Avenue 5/1, 251, E-mail: utegenova.a@amu.kz, Phone: + 7 777 984 8400 - laboratory frequency of heating work
Zharmaganbetova Baglan – Head of the Infectious Diseases Department No. 6, "Multidisciplinary City Children's Hospital No. 3" , postal address: 010000, Astana, 31-19 Chingiz Aitmatov St., Phone: +7 771 103 20 09 , E-mail: – b.olzhabayevna@mail.ru, interpretation of the research results- patient consultation, interpretation of study results.
Seidullayeva Aliya - MD, PhD, Associate Professor of the Department of Pediatric Infectious Diseases of the National Academy of Sciences of Astana Medical University, doctor on duty at the State Clinical Hospital for Pediatric Diseases of the Multidisciplinary City Children's Hospital No. 3, postal address: 010000 Astana, Sultan Beybarys 25/4, 17, 1, Phone: +7 701 186 03 03 E-mail: seidullayeva.aliya@gmail.com , https://orcid.org/0000-0002-7513-5677 - substantiation of the research concept (formulation of the idea, research goals and objectives), сбор биоматериала writing the text of the manuscript, design of the manuscript.
1. Ali M., Chang B.A., Johnson K.W., Morris S.K. Incidence and aetiology of bacterial meningitis among children aged 1–59 months in South Asia: systematic review and meta-analysis. Vaccine. 2018.36(39):5846–57. DOI: 10.1016/j.vaccine.2018.07.037.
2. Babenko D., Seidullayeva A., Bayesheva D., Turdalina B. Kozhakhmetov S. Ability of Procalcitonin and C-Reactive Protein for Discriminating between Bacterial and Enteroviral Meningitis in Children Using Decision Tree. BioMed Research International, Volume 2021, Article ID 5519436, 7 pages. DOI: 10.1155/2021/5519436.
3. Cornelis N. van Ettekoven, Fabian D. Liechti, Matthijs C. Brouwer Global Case Fatality of Bacterial Meningitis During an 80-Year Period A Systematic Review and Meta-Analysis/jamanetworkopen.2024.1 августа. 7(8): e2424802. DOI: 10.1001
5. Cohen R., Varon E., Béchet S. et al. Comparative impact of pneumococcal conjugate vaccines on pneumococcal meningitis according to underlying conditions. Vaccine. 2016. Vol. 34(41). 4850-4856. DOI: 10.1016/j.vaccine.2016.08.069
6. Hubert-Dibon G., Danjou L., Feildel-Fournial C. et al. Procalcitonin and C-reactive protein may help to detect invasive bacterial infections in children who have fever without source // Acta Paediatr. 2018. Vol. 107(7). P. 1262-1269. DOI: 10.1111/apa.14248
7.Iwata S, Takata M, Morozumi M, et al. Drastic reduction in pneumococcal meningitis in children owing to the introduction of pneumococcal con jugate vaccines: Longitudinal analysis from 2002 to 2016 in Japan. J Infect Chemother. 2021;27(4): 604–12. DOI: 10.1016/j.jiac.2020.11.019.
8. Kuschke S., Goncalves N., Peer S. Hearing outcomes in children's hospital, cape town, south Africa: a silent crisis // S Afr Med J. 2018. Vol. 108(11). P. 944-946. DOI: 10.7196/SAMJ.2018.v108i11.13067.
9. Lai X., Wahl B., Yu W., et al. National, regional, and provincial disease burden attributed to Streptococcus pneumoniae and Haemophilusinfluenzae type b in children in China: Modelled estimates for 2010–17. Lancet Reg Health WestPac. 2022; 22: 100430. DOI: 10.1016/j.lanwpc.2022.100430
10. Lai Y.R., Lin J.R., Chang W.N. et al. Outcomes of adjunctive steroid therapy in adult patients with bacterial meningitis in Taiwan: A nationwide population-based epidemiologic study. Journal of Clinical Neuroscience. 2019. Vol. 61. P. 54-58. DOI: 10.1016/j.jocn.2018.10.146
11. Mao D-H., Miao J-K., Zou X., Chen N., Yu L-C., Lai X., Qiao M-Y. and Chen Q-X. .Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis. A Systematic Review. Front. Neurol. October. 2019. Volum 10. 10:1119. DOI: 10.3389/fneur.2019.01119.
12. McIntyre P.B., O’Brien K.L., Greenwood B., van de Beek D. Effect of vaccines on bacterial meningitis worldwide. Lancet. 2012; 380(9854):1703-1711. DOI: 10.1016/S0140-6736(12)61187-8.
13. Morton F., Martinot A., Assathiany R., Roué J.M., Bourgoin P., Chantreuil J., et al. Epidemiology of Community-Onset Severe Bacterial Infections in Children and Its Evolution: A Population-Based Study in France. Pediatr Crit Care Med 2020;21(6):p e325–e32. pmid:32224829. DOI: 10.1097/PCC.0000000000002300.
14. Mazumder S., Ramya B.S., Biligi D.S. Utility of urine reagent strips in cerebrospinal fluid analysis: An aid to bedside diagnosis of meningitis. Indian Journal of Pathology and Microbiology. 2018. Vol. 61(3):356-359. DOI: 10.4103/IJPM.IJPM_821_16.
15. Russell N.J., Seale A.C., O’Sullivan C. et al. Risk of Early-Onset Neonatal Group B Streptococcal Disease With Maternal Colonization Worldwide: Systematic Review and Meta-analyses. Clinical Infectious Diseases. 2017. Vol. 65, Suppl. 2. P. S152-S159. DOI: 10.1093/cid/cix655.
16. Rodrigues C.M.C., Maiden M.C.J. A world without bacterial meningitis: how genomic epidemiology can inform vaccination strategy. F1000 Research. 2018. Vol. 7. 401, 1. DOI: 10.12688/f1000research.13793.1.
17. Shevtsov A., Aushakhmetova Z, Amirgazin A, Khegay O. Whole genome sequence analysis of Neisseria meningitidis strains circulating in Kazakhstan, 2017–2018. PLoS One. 2022 Dec 28. DOI: 10.1371/journal.pone.0279536.
18. Seidullayeva A., Bayesheva D., Turdalina, B., Elubayeva, A., Kozhakhmetov, S. Sensorineural hearing loss after bacterial meningitis in children residing in Nur-sultan. Infektsionnye Bolezni, 2020, 18(4), 189–194. DOI: 10.20953/1729-9225-2020-4-189-194.
19. Tyler J. Runde, Fatima Anjum, John W. Hafner. Bacterial Meningitis In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2025 Jan.2023 Aug 8. PMID: 29261975 Bookshelf ID: NBK470351.
20. Willems Jef., Hermans Eline, Schelstraete Petra. Optimizing the Use of Antibiotic Agents in the Pediatric Intensive Care Unit: A Narrative Review. Pediatric Drugs (2021) 23:39–53. DOI:10.1007/s40272-020-00426-y.
21. Zeeshan F., Bari A., Duga M.N., Saeed F. Hearing impairment after acute bacterial meningitis in children. Pak J Med Sci. 2018. Vol. 34(3). 655-659. DOI: 10.12669/pjms.343.14373.
22. Zainel A, Mitchell H, Sadarangani M. Bacterial meningitis in children: neurological complications, associated risk factors, and prevention. Microorganisms. 2021. 9(3):535. DOI:10.3390/microorganisms9030535.
23. De JongeR.C.J. et al. Predicting sequelae and death after bacterial meningitis in childhood: A systematic review of prognostic studies de Jongeet al // BMC Infectious Diseases. – 2010. – Vol. 10(1). – P. 232.
Количество просмотров: 52
Категория статей:
Оригинальное исследование
Библиографическая ссылка
Baesheva D.A., Zhumagalieva G.D., Kosherova B.N., Turdalina B.R., Altynbekova A.V., Kubekova S.Zh., Zhuzzhasarova A.A., Utegenova A.M., Zharmaganbetova B.O., Seidullayeva A.Zh. Clinical features and complications of bacterial meningitis in children // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (2), pp. 87-98. doi 10.34689/SH.2025.27.2.011Похожие публикации:
VIRAL HEPATITIS IN KAZAKHSTAN: REGIONAL EPIDEMIOLOGICAL OVERVIEW
PREDICTORS OF ANTIVIRAL THERAPY INEFFECTIVENESS IN CHRONIC HEPATITIS C: A MATCHED CASE-CONTROL STUDY IN ALMATY, A MAJOR METROPOLIS OF KAZAKHSTAN
МЕДИКО – СОЦИАЛЬНЫЕ ОСОБЕННОСТИ ПРИВЕРЖЕННОСТИ К ЛЕЧЕНИЮ БОЛЬНЫХ С ХРОНИЧЕСКИМ ПАНКРЕАТИТОМ
PATHOGENETIC ASSESSMENT OF CLINICAL AND INSTRUMENTAL PARAMETERS OF THE LUNGS IN PATIENTS WITH DIABETES MELLITUS
THE FREQUENCY AND EFFICACY ASSESSMENT OF RADIOIODINE THERAPY FOR DISTANT METASTASES OF THYROID CANCER