Acute bacterial meningitis in Polish children – assessment of risk factors of neurological complications

Introduction:
Bacterial meningitis remains a potential problem for contemporary pediatrics, as regards both treatment and further care of patients with long-term complications. The aim of this study is to identify the most common neurological complications of acute bacterial meningitis among children and their main risk factors of occurrence.

Material and methods:
We analyzed data on cases of children with bacterial meningitis hospitalized in The Infectious Diseases Department in St. Joseph Children’s Hospital in Poznan, between 2010 and 2020. We considered Streptococcus pneumoniae and Neisseria meningitidis as etiological factors. Data on neurological complications were obtained during follow-up visits and as a result of telephone surveys.

Results:
We identified 75 patients (1 month up to 17 years of age) with acute bacterial meningitidis with the etiological factors Streptococcus pneumoniae and Neisseria meningitidis; 2 of them died as a result of infection (2.66%). Data on short and long-term complications were obtained from 59 patients. We observed complications among 42 children; the most frequent complications were cognitive impairment (31.37%), subdural effusion (17.19%), focal neurological deficits (15.6%), and hearing disorders (14.0%). Patients with neurological complications showed a higher frequency of lower count of neutrophils < 13.8 × 10³/μl (p < 0.01), a lower hemoglobin level < 12.0 g/dl (p < 0.00), and platelet levels above 340 x 10³/μl (p < 0.02). Risks factors of neurological complications occurrence were irritability at admission (p < 0.04) , age of patients under 34 months (95 CI%: 0.58–0.86), and length of hospitalization over 14 days (95 CI%: 0.70–0.92).

Conclusions:
Despite the introduction of protective vaccination, bacterial meningitis is still a life-threatening disease that leads to significant neurological consequences. It is important to recognize patients with risk factors of neurological complications to provide them with multidisciplinary medical care later in life.