Delayed Cerebrospinal Fluid Sterilization and Adverse Outcome of Bacterial Meningitis in Infants and Children
Delayed Cerebrospinal Fluid Sterilization and Adverse Outcome of Bacterial Meningitis in Infants and Children
复制标题
婴儿和儿童脑脊液灭菌延迟和细菌性脑膜炎的不良后果
DOI：
10.1542/peds.83.2.161
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发表时间：
1989
期刊：
影响因子：
8
通讯作者：
G. Mccracken
中科院分区：
文献类型：
--
作者：
M. Lebel;G. Mccracken
为了确定脑脊液培养对使用新型头孢菌素治疗的脑膜炎患者的病原体持续阳性的临床意义，回顾了前瞻性参加头孢呋辛或头孢曲松治疗的4项临床疗效试验的301例细菌性脑膜炎婴儿和儿童的记录。20例患者的CSF培养结果为阳性，281例患者在治疗开始后18至36小时无菌。癫痫发作，硬膜下积液，偏瘫被发现在那些延迟消毒脑脊液住院期间更常见。与脑脊液及时消毒的儿童相比，培养持续阳性的儿童在出院时（45%对19%）和随访时（41%对13%）神经系统异常和中度至重度听力障碍的发生率显著较高（35%对15%）。反复脑脊液检查是婴幼儿细菌性脑膜炎的一个有用的预后指标。
To determine the clinical importance of CSF cultures that are persistently positive for pathogens in patients treated for meningitis with the new cephalosporins, the records of 301 infants and children with bacterial meningitis enrolled prospectively in four clinical efficacy trials of cefuroxime or ceftriaxone therapy were reviewed. CSF culture results were positive for 20 patients and they were sterile at 18 to 36 hours after start of therapy for 281 patients. Seizures, subdural effusions, and hemiparesis were found significantly more often during hospitalization in those with delayed sterilization of CSF. Children with persistently positive cultures had a significantly higher incidence of neurologic abnormalities at the time of hospital discharge (45% v 19%) and at followup (41% v 13%) and of moderate to profound hearing impairment (35% v 15%) than did those with prompt sterilization of CSF. Repeat CSF examination is a useful prognostic indicator in infants and young children with bacterial meningitis.