Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011-2014
Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011-2014
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DOI：
10.1097/inf.0000000000002081
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发表时间：
2019-01-01
影响因子：
3.6
通讯作者：
Ginocchio, Christine C.
中科院分区：
文献类型：
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作者：
Hasbun, Rodrigo;Wootton, Susan H.;Ginocchio, Christine C.
背景资料：在美国，缺乏对婴儿和儿童脑膜炎和脑炎的病因、管理决策和结局进行评估的大型流行病学研究。研究方法：分析了2011-2014年期间根据国际疾病分类第九版（Premier Healthcare Database中可用的代码）评估的0-17岁脑膜炎或脑炎儿童。结果如下：确定了6665例脑膜炎或脑炎患者; 3030例（45.5%）年龄小于1岁，295例（4.4%）年龄为1-2岁，1460例（21.9%）年龄为3-9岁，1880例（28.2%）年龄为10-17岁。病因包括肠道病毒（58.4%）、未知（23.7%）、细菌（13.0%）、非感染性（3.1%）、单纯疱疹病毒（1.5%）、其他病毒（0.7%）、虫媒病毒（0.5%）和真菌（0.04%）。大多数患者为男性[3847例（57.7%）]和健康[6094例（91.4%）]，未报告基础疾病。大多数患者在急诊科接受了腰椎穿刺[5363例（80%）]，并入院[5363例（83.1%）]。1岁以下儿童抗生素治疗频率最高（92.2%），占97.7%。抗病毒治疗较少见（31.1%）。6665例患者中仅539例（8.1%）接受了类固醇治疗。早期应用类固醇激素与死亡率降低无关（P = 0.266）。总体住院时间中位数为2天。总死亡率（0.5%）和再入院率（
Background: Large epidemiologic studies evaluating the etiologies, management decisions and outcomes of infants and children with meningitis and encephalitis in the United States are lacking. Methods: Children 0-17 years of age with meningitis or encephalitis as assessed by International Classification of Diseases, Ninth Revision, codes available in the Premier Healthcare Database during 2011-2014 were analyzed. Results: Six thousand six hundred sixty-five patients with meningitis or encephalitis were identified; 3030 (45.5%) were younger than 1 year of age, 295 (4.4%) were 1-2 years of age, 1460 (21.9%) were 3-9 years of age, and 1880 (28.2%) were 10-17 years of age. Etiologies included enterovirus (58.4%), unknown (23.7%), bacterial (13.0%), noninfectious (3.1%), herpes simplex virus (1.5%), other viruses (0.7%), arboviruses (0.5%) and fungal (0.04%). The majority of patients were male [3847 (57.7%)] and healthy [6094 (91.4%)] with no reported underlying conditions. Most underwent a lumbar puncture in the emergency department [5363 (80%)] and were admitted to the hospital [5363 (83.1%)]. Antibiotic therapy was frequent (92.2%) with children younger than 1 year of age with the highest rates (97.7%). Antiviral therapy was less common (31.1%). Only 539 (8.1%) of 6665 of patients received steroids. Early administration of adjunctive steroids was not associated with a reduction in mortality (P = 0.266). The overall median length of stay was 2 days. Overall mortality rate (0.5%) and readmission rates (