The early prognosis at the bacterial meningitis
https://doi.org/10.22625/2072-6732-2011-3-1-40-47
Abstract
On the basis of the studying of clinical and laboratory sings of 150 cases of bacterial meningitis (BM) with the use of various statistical methods, including multivariate logistical regression analysis, the early prognostic criteria of the maximum risk and the relation of chances of the maximum risk of an acyclic (severe, complicated, including lethal) variant of a diseases were estimated. These criteria are: age of the patient ≥ 55 years, late hospitalisation (≥3 days of disease), the expressed disturbances of consciousness (coma), episodes of generalized cramps in acute period, presence of “focal” neurologic sings, also the CSF protein level ≥2,7 g/l, and also factor size «a glucose of CSF/glucose of serum» <0,2 at primary (diagnostic) Lp. Using of an offered logistical regression models allows to prognosticate an aciclic variant of BM with efficiency of 92 %, at specificity of 90,6 % and sensitivity of 93 % in some hours after getting to the hospital.
About the Authors
Yu. V. Lobzin
St-Petersburg Medical Academy of Postgraduate Studies, Saint-Petersburg
Russian Federation
Russian Federation
V. V. Pilipenko
St-Petersburg Medical Academy of Postgraduate Studies, Saint-Petersburg
Russian Federation
Russian Federation
M. V. Rezvansev
Military Medical Academy named by S.M. Kirov, Saint-Petersburg
Russian Federation
Russian Federation
References
1. Brandtzaeg, P. Meningococcal infections at the start of the 21st century / P. Brandtzaeg, M. van Deuren // Adv. Pediatr. – 2005. – V. 52. – P. 129–162.
2. Heckenberg, S.G. Clinical features, outcome, and meningococcal genotype in 258 adults with meningococcal meningitis: a prospective cohort study / S.G. Heckenberg [et al.] // Medicine (Baltimore). – 2008. – V. 87, №4. – P. 185–192.
3. Swartz, M.N. Bacterial meningitis – a view of the past 90 years / M.N. Swartz // N. Engl. J. Med. – 2004. – V. 351, № 18. – P. 1826–1828.
4. Wilder-Smith, A. Hajj-associated outbreak of Neisseria meningitides serogroup W135: Estimates of the attack rate in defined population and the risk of invasive disease developing in carriers / A. Wilder-Smith [et al.] // Clin. Infect. Dis. – 2003. – V. 36. – P. 679–683.
5. Zombre, S. The outbreak of meningitis due to Neisseria meningitidis W135 in 2003 in Burkina Faso and the national response: main lessons learnt / S. Zombre [et al.] // Vaccine. – 2007. – V. 25. – Suppl. 1. – P. 69–71.
6. Arda, B. Pooled analysis of 2,408 cases of acute adult purulent meningitis from Turkey / B. Arda [et al.] // Med. Princ. Pract. – 2008. – V. 17, № 1. – P. 76–79.
7. Королева, И.С. Менингококковая инфекция и гнойные бактериальные менингиты: руководство по лабораторной диагностике / И.С. Королева, Г.В. Белошицкий ; под ред. академика РАМН В.И. Покровского. – М: ООО «Медицинское информационное агентство», 2007. – 112 с.
8. Hussein, A.S. Acute bacterial meningitis in adults. A 12-year review / A.S. Hussein, S.D. Shafran // Medicine (Baltimore). – 2000. – V. 79, № 6. – P. 360–368.
9. Лобзин, Ю.В. Бактериальные менингиты / Ю.В. Лобзин, В.В. Пилипенко // Избранные вопросы терапии инфекционных больных ; под общ. ред. чл.-корр. РАМН проф. Ю.В. Лобзина. – СПб.: ООО «Издательство ФОЛИАНТ», 2005. – С. 879–897.
10. Сорокина, М.Н. Бактериальные менингиты у детей /М.Н. Сорокина, В.В. Иванова, Н.В. Скрипченко. – М.: Медицина, 2003. – 320 с.
11. Khwannimit, B. Acute bacterial meningitis in adults: a 20 year review / B. Khwannimit, P. Chayakul, A. Geater //Southeast Asian J. Trop. Med. Public Health. – 2004. – V. 35, № 4. – P. 886–892.
12. Korsholm, J. Sequelae and death following pneumococcal meningitis / J. Korsholm [et al.] // Ugeskr Laeger. – 2009. – V. 171, № 18. – P. 1481–1485.
13. Worsøe, L. Factors associated with the occurrence of hearing loss after pneumococcal meningitis / L. Wors e, P. Cayé-Thomasen, C.T. Brandt // Clin. Infect. Dis. – 2010. – V. 51, № 8. – P. 917–924.
14. Юнкеров, В.И. Математико-статистическая обработка данных медицинских исследований / В.И. Юнкеров, С.Г. Григорьев. – СПб.: ВМедА, 2005. – 292 с.
15. Реброва, О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA /О.Ю. Реброва. – М.: Медиа Сфера, 2003. – 305 с.
16. Приоритетная заявка на патент «Способ прогнозирования течения бактериальных гнойных менингитов» / В.В. Пилипенко, Ю.В. Лобзин, М.В. Резванцев, А.М. Алексеев. – Приоритетная справка №2010146608 от 16.11.2010.
17. Viallon, A. Decrease in serum procalcitonin levels over time during treatment of acute bacterial meningitis / A. Viallon [et al.] // Crit. Care. – 2005. – V. 9, № 4. – P. 344–350.
18. Mary, R. Acute meningitidis, acute phase proteins and procalcitonin / R. Mary, F. Veinberg, R. Couderc // Ann. Biol. Clin. – 2003. – V. 61, № 2. – P. 127–137.
19. Hoen, B. Mortality in pneumococcal meningitis: a multivariate analysis of prognostic factors / B. Hoen [et al.] //Eur. J. Med. – 1993. – V. 2, № 1. – P. 28–32.
20. Van de Beek, D. Clinical features and prognostic factors in adults with bacterial meningitis / D. Van de Beek [et al.] //N. Engl. J. Med. – 2004. – V. 351, № 18. – P. 18 49–1859.
21. Zoons, E. Seizures in adults with bacterial meningitis /E. Zoons [et al.] // Neurology. – 2008. – V. 70 (22 Pt2). – P. 2109–2115.
Review
For citations:
Lobzin Yu.V., Pilipenko V.V., Rezvansev M.V. The early prognosis at the bacterial meningitis. Journal Infectology. 2011;3(1):53-58. (In Russ.) https://doi.org/10.22625/2072-6732-2011-3-1-40-47
Views:
769
.png)
.png)
Email this article 