Prevalence and Outcomes of Pediatric Central Nervous System Infections: a Population-Based Analysis
Andrej Roczkowsky1, Nathan Armani2, Jeffrey Bakal2, Christopher Power1
1University of Alberta, 2Provincial Research Data Services, Alberta Health Services
Objective:
To quantify the prevalence and outcomes in children with central nervous system infections in a population-based cohort using administrative datasets.
Background:
In pediatric populations, infections of the central nervous system (CNS), including encephalitis, meningitis, and encephalomyelitis are medical emergencies requiring timely diagnosis and treatment to avoid mortality and adverse neurological consequences. The most common microbial pathogens causing CNS infections in children are viruses and bacteria although often no specific infectious pathogen is identified. We performed a population-based study of pediatric CNS infections utilizing province-wide de-identified databases, curated by the Alberta Strategy for Patient Orientation and Research Unit (AbSPORU).
Design/Methods:
We investigated microbial etiology, comorbidities, patient demographics, and outcomes of pediatric CNS infections corresponding to encephalitis, meningitis and encephalomyelitis through linked health service records for all pediatric patients (0-18 years) in Alberta, Canada (4.4 million persons) from 2004-2019. Infectious agents were identified from laboratory results for cerebrospinal fluid (CSF) from patients within 6 months from index date.
Results:
Among pediatric patients (n=1349) with diagnoses related to CNS infections, CSF results (n=454) were available from which CSF cultures were positive for bacteria (n=199), with the most common species being S. pneumoniae (n=53), group B streptococcus (n=33), and E. coli (n=24). Viral PCR analyses of CSF (n=46) detected enterovirus (n=19), herpes simplex virus (HSV) type 1 (n=11), and HSV type 2 (n=9). Concurrent bacterial and viral detection was also evident in CSF (n=2). Forty-nine patients were re-hospitalized within the first thirty days and 14 died. In the 3-12 month time frame 101 patients were re-hospitalized and 44 died.
Conclusions:
Among pediatric patients with suspected CNS infections, CSF analyses showed that only 54% had an identifiable microbial etiology, with bacterial meningitis as the most frequent diagnosis. These findings underscore the ongoing importance in defining the causes of encephalitis and meningitis in children with CNS infections.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.