Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A clinical study of child bacterial meningitis in Daejeon and Chungcheong area : 2001-2005

대전·충청 지역의 소아 세균성 수막염에 대한 임상적 연구 : 2001-2005

  • Lee, Yong Joo (Department of Pediatrics, Eulji University School of Medicine) ;
  • Lee, Soo Jin (Department of Pediatrics, Eulji University School of Medicine) ;
  • Park, Ho Jin (Department of Pediatrics, Eulji University School of Medicine) ;
  • Lee, Young Hyuk (Department of Pediatrics, Konyang University College of Medicine) ;
  • Kang, So Young (Department of Pediatrics, Dankook University College of Medicine) ;
  • Kim, Young Chang (Department of Pediatrics, Soonchunhyang University College of Medicine) ;
  • Lee, In Kyu (Department of Pediatrics, Soonchunhyang University College of Medicine) ;
  • Lee, Kyung Yeon (Department of Pediatrics, The Gatholic University College of Medicine) ;
  • Lee, Keon Su (Department of Pediatrics, Chungnam National University College of Medicine) ;
  • Kim, Won Seop (Department of Pediatrics, Chungbuk National University College of Medicine)
  • 이용주 (을지의과대학교 소아과학교실) ;
  • 이수진 (을지의과대학교 소아과학교실) ;
  • 박호진 (을지의과대학교 소아과학교실) ;
  • 이영혁 (건양대학교병원 소아과학교실) ;
  • 강소영 (단국의대 천안병원 소아과학교실) ;
  • 김영창 (순천향의대 천안병원 소아과학교실) ;
  • 이인규 (순천향의대 천안병원 소아과학교실) ;
  • 이경연 (청주성모병원 소아과학교실) ;
  • 이건수 (충남대학교병원 소아과학교실) ;
  • 김원섭 (충북대학교병원 소아과학교실)
  • Received : 2006.12.13
  • Accepted : 2006.01.15
  • Published : 2007.02.15
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Abstract

Purpose : The purpose of this study was to analyze the epidemiology, causative organism, clinical manifestation and prognosis of bacterial meningitis for children after the introduction of Haemophilus influenzae type b (Hib) vaccine in Daejeon and Chungcheong area. Methods : We analyzed retrospectively 53 medical records who had been diagnosed with bacterial meningitis at 10 general or university hospitals in Daejeon and Chungcheong area. All patients aged 1 month-14 years admitted between January 2001 through December 2005. Results : During the 5-year study period, 40 of all cases were positive for bacterial growth. Of the 40 cases that were CSF culture-proven bacterial meningitis, Streptococcus peumoniae was the most common bacteria for 17 (32.1%) of all cases, followed by H. influenzae for 10 (18.9%), Neisseria meningitidis for 3 (5.7%). In this study, the most common clinical manifestation is fever, accompanied by all cases. CSF leukocyte count was more than $100/mm^3$ in 45 (84.1%) cases. CSF glucose concentration was less than 50 mg/dL in 42 (79.2%) cases and protein concentration was more than 45 mg/dL in 49 (92.5%) cases. 45 of all cases made a recovery after treatment and were discharged. Most common complication after treatment is subdural effusion (19.0%) and hearing disturbance (9.4%). Conclusion : The most common organism of culture-proven bacterial meningitis in the children beyond neonatal period was S. pneumoniae. Continued surveillance studies were demanded to know the altered incidence of bacterial meningitis, because we expect the incidence of S. pneumoniae meninigitis will be on the decrease after more active innoculation of pneumococcal protein conjugate vaccine.

목 적: 최근 5년간 대전충청 지역에서 세균성 수막염의 원인균과 역학, 임상 양상, 경과 및 예후에 대하여 알아보고자 하였다. 방 법: 2001년 1월부터 2005년 12월까지 만 5년간 대전충청 지역의 10개 종합병원 소아과에서 세균성 수막염으로 진단받았던 1개월부터 만 15세까지의 53례를 대상으로 하여 원인균을 중심으로 발생 빈도와 역학을 알아보았다. 결 과: 대전충청 지역에서 최근 5년간 발생한 소아 세균성 수막염 53례 중 40례에서 균이 배양되었고, 원인균은 S. pneumoniae(32.1%), H. influenzae(18.9%), N. meningitidis(5.7%) 등의 순서로 나타났다. 임상증상으로 발열이 전례에서 있었고, 뇌척수액 검사에서 대부분 백혈구 수는 $100/mm^3$ 이상(88.3%), 당량은 50 mg/dL 미만(79.2%), 단백량은 45 mg/dL 이상(92.4%)이었다. 53례 중 45례(84.9%)는 호전되어 퇴원하였고, 합병증은 경막하삼출(19.0%)과 청력장애(9.4%)가 가장 많았다. 결 론: 대전충청지역에서 최근 5년간 발생한 수막염의 가장 흔한 원인균은 S. pneumoniae로, 폐구균 단백 결합 백신 접종이 활성화되면 S. pneumoniae에 의한 수막염의 발생율은 감소할 것으로 보인다.

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