Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors

Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Daniela Maturana Martínez [verfasserIn] David Aguilera-Alonso [verfasserIn] Julia García Mancebo [verfasserIn] María Luisa Navarro [verfasserIn] Teresa Hernández Sampelayo [verfasserIn] Elena María Rincón López [verfasserIn] Begoña Santiago-García [verfasserIn] Jesús Saavedra-Lozano [verfasserIn] Mar Santos [verfasserIn] Emilia Cercenado [verfasserIn]

Format:	E-Artikel
Sprache:	Spanisch

Erschienen:	2019

Schlagwörter:	Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología

Übergeordnetes Werk:	In: Anales de Pediatría (English Edition) - Elsevier, 2021, 91(2019), 5, Seite 296-306
Übergeordnetes Werk:	volume:91 ; year:2019 ; number:5 ; pages:296-306

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1016/j.anpede.2019.09.001

Katalog-ID:	DOAJ058732837

Internformat


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520			\|a Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico.
650		4	\|a Neisseria meningitidis
650		4	\|a Sepsis
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700	0		\|a David Aguilera-Alonso \|e verfasserin \|4 aut
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700	0		\|a Teresa Hernández Sampelayo \|e verfasserin \|4 aut
700	0		\|a Elena María Rincón López \|e verfasserin \|4 aut
700	0		\|a Begoña Santiago-García \|e verfasserin \|4 aut
700	0		\|a Jesús Saavedra-Lozano \|e verfasserin \|4 aut
700	0		\|a Mar Santos \|e verfasserin \|4 aut
700	0		\|a Emilia Cercenado \|e verfasserin \|4 aut
773	0	8	\|i In \|t Anales de Pediatría (English Edition) \|d Elsevier, 2021 \|g 91(2019), 5, Seite 296-306 \|w (DE-627)833145525 \|w (DE-600)2830901-7 \|x 23412879 \|7 nnns
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allfields	10.1016/j.anpede.2019.09.001 doi (DE-627)DOAJ058732837 (DE-599)DOAJ5d8f95a3e40549b5a3d456b61a31dba9 DE-627 ger DE-627 rakwb spa RJ1-570 Daniela Maturana Martínez verfasserin aut Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico. Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología Pediatrics David Aguilera-Alonso verfasserin aut Julia García Mancebo verfasserin aut María Luisa Navarro verfasserin aut Teresa Hernández Sampelayo verfasserin aut Elena María Rincón López verfasserin aut Begoña Santiago-García verfasserin aut Jesús Saavedra-Lozano verfasserin aut Mar Santos verfasserin aut Emilia Cercenado verfasserin aut In Anales de Pediatría (English Edition) Elsevier, 2021 91(2019), 5, Seite 296-306 (DE-627)833145525 (DE-600)2830901-7 23412879 nnns volume:91 year:2019 number:5 pages:296-306 https://doi.org/10.1016/j.anpede.2019.09.001 kostenfrei https://doaj.org/article/5d8f95a3e40549b5a3d456b61a31dba9 kostenfrei http://www.sciencedirect.com/science/article/pii/S2341287919301589 kostenfrei https://doaj.org/toc/2341-2879 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 91 2019 5 296-306
spelling	10.1016/j.anpede.2019.09.001 doi (DE-627)DOAJ058732837 (DE-599)DOAJ5d8f95a3e40549b5a3d456b61a31dba9 DE-627 ger DE-627 rakwb spa RJ1-570 Daniela Maturana Martínez verfasserin aut Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico. Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología Pediatrics David Aguilera-Alonso verfasserin aut Julia García Mancebo verfasserin aut María Luisa Navarro verfasserin aut Teresa Hernández Sampelayo verfasserin aut Elena María Rincón López verfasserin aut Begoña Santiago-García verfasserin aut Jesús Saavedra-Lozano verfasserin aut Mar Santos verfasserin aut Emilia Cercenado verfasserin aut In Anales de Pediatría (English Edition) Elsevier, 2021 91(2019), 5, Seite 296-306 (DE-627)833145525 (DE-600)2830901-7 23412879 nnns volume:91 year:2019 number:5 pages:296-306 https://doi.org/10.1016/j.anpede.2019.09.001 kostenfrei https://doaj.org/article/5d8f95a3e40549b5a3d456b61a31dba9 kostenfrei http://www.sciencedirect.com/science/article/pii/S2341287919301589 kostenfrei https://doaj.org/toc/2341-2879 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 91 2019 5 296-306
allfields_unstemmed	10.1016/j.anpede.2019.09.001 doi (DE-627)DOAJ058732837 (DE-599)DOAJ5d8f95a3e40549b5a3d456b61a31dba9 DE-627 ger DE-627 rakwb spa RJ1-570 Daniela Maturana Martínez verfasserin aut Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico. Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología Pediatrics David Aguilera-Alonso verfasserin aut Julia García Mancebo verfasserin aut María Luisa Navarro verfasserin aut Teresa Hernández Sampelayo verfasserin aut Elena María Rincón López verfasserin aut Begoña Santiago-García verfasserin aut Jesús Saavedra-Lozano verfasserin aut Mar Santos verfasserin aut Emilia Cercenado verfasserin aut In Anales de Pediatría (English Edition) Elsevier, 2021 91(2019), 5, Seite 296-306 (DE-627)833145525 (DE-600)2830901-7 23412879 nnns volume:91 year:2019 number:5 pages:296-306 https://doi.org/10.1016/j.anpede.2019.09.001 kostenfrei https://doaj.org/article/5d8f95a3e40549b5a3d456b61a31dba9 kostenfrei http://www.sciencedirect.com/science/article/pii/S2341287919301589 kostenfrei https://doaj.org/toc/2341-2879 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 91 2019 5 296-306
allfieldsGer	10.1016/j.anpede.2019.09.001 doi (DE-627)DOAJ058732837 (DE-599)DOAJ5d8f95a3e40549b5a3d456b61a31dba9 DE-627 ger DE-627 rakwb spa RJ1-570 Daniela Maturana Martínez verfasserin aut Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico. Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología Pediatrics David Aguilera-Alonso verfasserin aut Julia García Mancebo verfasserin aut María Luisa Navarro verfasserin aut Teresa Hernández Sampelayo verfasserin aut Elena María Rincón López verfasserin aut Begoña Santiago-García verfasserin aut Jesús Saavedra-Lozano verfasserin aut Mar Santos verfasserin aut Emilia Cercenado verfasserin aut In Anales de Pediatría (English Edition) Elsevier, 2021 91(2019), 5, Seite 296-306 (DE-627)833145525 (DE-600)2830901-7 23412879 nnns volume:91 year:2019 number:5 pages:296-306 https://doi.org/10.1016/j.anpede.2019.09.001 kostenfrei https://doaj.org/article/5d8f95a3e40549b5a3d456b61a31dba9 kostenfrei http://www.sciencedirect.com/science/article/pii/S2341287919301589 kostenfrei https://doaj.org/toc/2341-2879 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 91 2019 5 296-306
allfieldsSound	10.1016/j.anpede.2019.09.001 doi (DE-627)DOAJ058732837 (DE-599)DOAJ5d8f95a3e40549b5a3d456b61a31dba9 DE-627 ger DE-627 rakwb spa RJ1-570 Daniela Maturana Martínez verfasserin aut Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico. Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología Pediatrics David Aguilera-Alonso verfasserin aut Julia García Mancebo verfasserin aut María Luisa Navarro verfasserin aut Teresa Hernández Sampelayo verfasserin aut Elena María Rincón López verfasserin aut Begoña Santiago-García verfasserin aut Jesús Saavedra-Lozano verfasserin aut Mar Santos verfasserin aut Emilia Cercenado verfasserin aut In Anales de Pediatría (English Edition) Elsevier, 2021 91(2019), 5, Seite 296-306 (DE-627)833145525 (DE-600)2830901-7 23412879 nnns volume:91 year:2019 number:5 pages:296-306 https://doi.org/10.1016/j.anpede.2019.09.001 kostenfrei https://doaj.org/article/5d8f95a3e40549b5a3d456b61a31dba9 kostenfrei http://www.sciencedirect.com/science/article/pii/S2341287919301589 kostenfrei https://doaj.org/toc/2341-2879 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 91 2019 5 296-306
language	Spanish
source	In Anales de Pediatría (English Edition) 91(2019), 5, Seite 296-306 volume:91 year:2019 number:5 pages:296-306
sourceStr	In Anales de Pediatría (English Edition) 91(2019), 5, Seite 296-306 volume:91 year:2019 number:5 pages:296-306
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institution	findex.gbv.de
topic_facet	Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología Pediatrics
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container_title	Anales de Pediatría (English Edition)
authorswithroles_txt_mv	Daniela Maturana Martínez @@aut@@ David Aguilera-Alonso @@aut@@ Julia García Mancebo @@aut@@ María Luisa Navarro @@aut@@ Teresa Hernández Sampelayo @@aut@@ Elena María Rincón López @@aut@@ Begoña Santiago-García @@aut@@ Jesús Saavedra-Lozano @@aut@@ Mar Santos @@aut@@ Emilia Cercenado @@aut@@
publishDateDaySort_date	2019-01-01T00:00:00Z
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language_de	spanisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ058732837</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230308225941.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230228s2019 xx \|\|\|\|\|o 00\| \|\|spa c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.anpede.2019.09.001</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ058732837</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ5d8f95a3e40549b5a3d456b61a31dba9</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">spa</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RJ1-570</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Daniela Maturana Martínez</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2019</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. 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callnumber-first	R - Medicine
author	Daniela Maturana Martínez
spellingShingle	Daniela Maturana Martínez misc RJ1-570 misc Neisseria meningitidis misc Sepsis misc Meningitis misc Morbilidad misc Epidemiología misc Pediatrics Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors
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topic_title	RJ1-570 Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors Neisseria meningitidis Sepsis Meningitis Morbilidad Epidemiología
topic	misc RJ1-570 misc Neisseria meningitidis misc Sepsis misc Meningitis misc Morbilidad misc Epidemiología misc Pediatrics
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title	Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors
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title_full	Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors
author_sort	Daniela Maturana Martínez
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author_browse	Daniela Maturana Martínez David Aguilera-Alonso Julia García Mancebo María Luisa Navarro Teresa Hernández Sampelayo Elena María Rincón López Begoña Santiago-García Jesús Saavedra-Lozano Mar Santos Emilia Cercenado
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title_sort	invasive meningococcal disease in children and adults in a tertiary level hospital. recent epidemiology and prognostic factors
callnumber	RJ1-570
title_auth	Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors
abstract	Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico.
abstractGer	Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico.
abstract_unstemmed	Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. La trombocitopenia, la leucopenia y el exantema purpúrico fueron factores de riesgo relacionados con peor pronóstico.
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container_issue	5
title_short	Invasive meningococcal disease in children and adults in a tertiary level hospital. Recent epidemiology and prognostic factors
url	https://doi.org/10.1016/j.anpede.2019.09.001 https://doaj.org/article/5d8f95a3e40549b5a3d456b61a31dba9 http://www.sciencedirect.com/science/article/pii/S2341287919301589 https://doaj.org/toc/2341-2879
remote_bool	true
author2	David Aguilera-Alonso Julia García Mancebo María Luisa Navarro Teresa Hernández Sampelayo Elena María Rincón López Begoña Santiago-García Jesús Saavedra-Lozano Mar Santos Emilia Cercenado
author2Str	David Aguilera-Alonso Julia García Mancebo María Luisa Navarro Teresa Hernández Sampelayo Elena María Rincón López Begoña Santiago-García Jesús Saavedra-Lozano Mar Santos Emilia Cercenado
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doi_str	10.1016/j.anpede.2019.09.001
callnumber-a	RJ1-570
up_date	2024-07-03T19:46:12.829Z
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Recent epidemiology and prognostic factors</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2019</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: Invasive meningococcal disease (IMD) has a high morbidity and mortality in children and adults. The aim of this study was to describe the clinical and epidemiological characteristics of patients with IMD, to compare them among children and adults, and to determine prognostic factors and changes in epidemiology during a 14-year period. Methods: A retrospective study was conducted on patients admitted to a third level hospital with IMD between 2004 and 2017. An analysis was made of the clinical, epidemiological and microbiological data. Results: A total of 84 patients were diagnosed with IMD, of which 50 (59.5%) were children. Median age was 2 years (IQR 0.7–7.5) for children and 41.2 years (IQR 26.4–69.3) for adults. Diagnosis was bacteraemia in 47 patients (56%), meningitis in 24 (28.6%), and both in 13 (15.5%). Serogroup B (MenB) was the most common cause of IMD (40.5%), followed by serogroup C (MenC) in 15.5%, which was more common among adults (26.5% vs 8%, P = .022). Incidence rate decreased between 2004–2010 and 2011–2017, from 3.14 to 1.33 cases/100 000 emergencies attended in the study hospital (P < .001). Eighty-four percent of children had received ≥1 dose of vaccine against MenC, with none against MenB. Children had higher proportion of ICU admissions (78% vs 44.1%, P = .001). Mortality was slightly higher in adults (11.8% vs 2.0%, P = .153). Adverse outcomes (sequelae or mortality) were independently associated with intubation and thrombocytopenia, while disease severity with leukopenia and purpuric rash. Conclusions: IMD incidence has decreased in our setting, with MenB being the most common serogroup. The higher prevalence of MenC in adults was probably related to lower vaccination coverage. According to this study, thrombocytopenia, leukopenia, and purpuric rash were parameters associated with worse outcome. Resumen: Introducción: La enfermedad meningocócica invasiva (EMI) supone una causa importante de morbimortalidad en niños y adultos. Objetivo principal: describir las características clínicas y epidemiológicas de los pacientes con EMI. Objetivos secundarios: describir las diferencias entre niños y adultos, factores pronósticos y cambios epidemiológicos en los últimos 14 años. Métodos: Estudio retrospectivo realizado en un hospital terciario. Se incluyeron los pacientes diagnosticados de EMI entre 2004 y 2017, recogiéndose datos epidemiológicos, clínicos y microbiológicos. Resultados: Fueron diagnosticados 84 pacientes con EMI, 50 (59,5%) niños. Edad mediana en niños 2 años (RIC: 0,7-7,5) y adultos 41,2 años (RIC: 26,4-69,3). Bacteriemia en 47 casos (56%), meningitis en 24 (28,6%) y ambas en 13 (15,5%). Predominio del serogrupo B (MenB), en el 40,5%, seguido del serogrupo C (MenC), en el 15,5%, con mayor proporción de MenC en adultos (26,5 vs. 8%; p = 0,022). Disminución en la incidencia de 2004-2010 a 2011-2017, pasando de 3,14 a 1,33 casos/100.000 urgencias en el centro de estudio (p < 0,001). El 84% de los niños había recibido ≥ 1 dosis de vacuna frente a MenC, ninguno frente a MenB. Mayor proporción de ingreso en UCI en niños (78 vs. 44,1%; p = 0,001). Tendencia a mayor letalidad en adultos (11,8 vs. 2%; p = 0,153). La intubación y la trombocitopenia fueron factores de riesgo independientes de desenlace adverso, y la leucopenia y el exantema purpúrico de gravedad. Conclusiones: Se objetivó un descenso en la incidencia de EMI, siendo MenB el mayoritario. El mayor porcentaje de MenC en adultos probablemente esté relacionado con una menor cobertura vacunal. 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