Meningococcal infection in children: factors influencing outcome

Generalized forms of meningococcal infection are characterized by high risk of complication and fatal outcomes. In Russian Federation, 2016, meningococcal infection was the second most common cause of pediatric deaths (25%) due to infectious diseases after community associated-pneumonia. Mandatory v...

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Main Authors: O. V. Samodova, E. A. Krieger, L. V. Titova, O. Yu. Leonteva
Format: Article
Language:Russian
Published: Journal Infectology 2019-10-01
Series:Журнал инфектологии
Subjects:
Online Access:https://journal.niidi.ru/jofin/article/view/926
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author O. V. Samodova
E. A. Krieger
L. V. Titova
O. Yu. Leonteva
author_facet O. V. Samodova
E. A. Krieger
L. V. Titova
O. Yu. Leonteva
author_sort O. V. Samodova
collection DOAJ
description Generalized forms of meningococcal infection are characterized by high risk of complication and fatal outcomes. In Russian Federation, 2016, meningococcal infection was the second most common cause of pediatric deaths (25%) due to infectious diseases after community associated-pneumonia. Mandatory vaccination against meninococcal infection is not regulated, and immunization coverage according to epidemic indications is insufficient. During first 6–8 hours of illness clinical signs of this infection may be non-specific, because of that it is difficult to make correct diagnosis at outpatient department. Aim of the study was to analyze mistakes of diagnostics of meningococcal infection and to assess factors influencing the disease outcome. Material and methods. Retrospective cohort study was performed including 113 pediatric cases of generalized meningococcal infection occurred in Arkhangelsk region (46 cases with fatal outcome and 67 patients, who recovered). Factors influencing the outcome were recognized using Cox regression. Results. Median age of patients was 11 months. Clinical forms were meningitis (13,3%), meningococcemia (40,7%), mixed form (46%). The diagnosis of meningococcal infection was made at outpatient department in 36,9% of cases. The main causes of diagnostic mistakes were the lack of experience among primary care physicians and non-specificic symptoms during the first hours of the disease. Age younger 2 years, septic shock and time between onset of the diseases and admission to the hospital were associated with fatal outcome. Conclusion. To manage meningococcal disease we need to have good compliance with clinical guidelines for outpatient departments and hospitals; to optimize medical students education for prevention of diagnostic mistakes. Vaccination is the most effective method of prevention of deaths associated with meningococcal infection.
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spelling doaj-art-8003e35edead43858cf2de87d3d0efe82025-08-20T03:44:24ZrusJournal InfectologyЖурнал инфектологии2072-67322019-10-01113131910.22625/2072-6732-2019-11-3-13-19734Meningococcal infection in children: factors influencing outcomeO. V. Samodova0E. A. Krieger1L. V. Titova2O. Yu. Leonteva3Northern State Medical UniversityNorthern State Medical UniversityNorthern State Medical UniversityNorthern State Medical UniversityGeneralized forms of meningococcal infection are characterized by high risk of complication and fatal outcomes. In Russian Federation, 2016, meningococcal infection was the second most common cause of pediatric deaths (25%) due to infectious diseases after community associated-pneumonia. Mandatory vaccination against meninococcal infection is not regulated, and immunization coverage according to epidemic indications is insufficient. During first 6–8 hours of illness clinical signs of this infection may be non-specific, because of that it is difficult to make correct diagnosis at outpatient department. Aim of the study was to analyze mistakes of diagnostics of meningococcal infection and to assess factors influencing the disease outcome. Material and methods. Retrospective cohort study was performed including 113 pediatric cases of generalized meningococcal infection occurred in Arkhangelsk region (46 cases with fatal outcome and 67 patients, who recovered). Factors influencing the outcome were recognized using Cox regression. Results. Median age of patients was 11 months. Clinical forms were meningitis (13,3%), meningococcemia (40,7%), mixed form (46%). The diagnosis of meningococcal infection was made at outpatient department in 36,9% of cases. The main causes of diagnostic mistakes were the lack of experience among primary care physicians and non-specificic symptoms during the first hours of the disease. Age younger 2 years, septic shock and time between onset of the diseases and admission to the hospital were associated with fatal outcome. Conclusion. To manage meningococcal disease we need to have good compliance with clinical guidelines for outpatient departments and hospitals; to optimize medical students education for prevention of diagnostic mistakes. Vaccination is the most effective method of prevention of deaths associated with meningococcal infection.https://journal.niidi.ru/jofin/article/view/926meningococcal infectionchildrenoutcomesvaccination
spellingShingle O. V. Samodova
E. A. Krieger
L. V. Titova
O. Yu. Leonteva
Meningococcal infection in children: factors influencing outcome
Журнал инфектологии
meningococcal infection
children
outcomes
vaccination
title Meningococcal infection in children: factors influencing outcome
title_full Meningococcal infection in children: factors influencing outcome
title_fullStr Meningococcal infection in children: factors influencing outcome
title_full_unstemmed Meningococcal infection in children: factors influencing outcome
title_short Meningococcal infection in children: factors influencing outcome
title_sort meningococcal infection in children factors influencing outcome
topic meningococcal infection
children
outcomes
vaccination
url https://journal.niidi.ru/jofin/article/view/926
work_keys_str_mv AT ovsamodova meningococcalinfectioninchildrenfactorsinfluencingoutcome
AT eakrieger meningococcalinfectioninchildrenfactorsinfluencingoutcome
AT lvtitova meningococcalinfectioninchildrenfactorsinfluencingoutcome
AT oyuleonteva meningococcalinfectioninchildrenfactorsinfluencingoutcome