Enfermedad meningocócica invasiva en niños y adultos en un hospital terciario: epidemiología reciente y factores pronósticos

  1. Daniela Maturana Martínez
  2. David Aguilera-Alonso
  3. Julia García Mancebo
  4. María Luisa Navarro Gómez
  5. Teresa Hernández-Sampelayo Matos
  6. Elena Rincón López
Journal:
Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

ISSN: 1695-4033 1696-4608

Year of publication: 2019

Volume: 91

Issue: 5

Pages: 296-306

Type: Article

More publications in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

Metrics

JCR (Journal Impact Factor)

  • Year 2019
  • Journal Impact Factor: 1.313
  • Journal Impact Factor without self cites: 1.012
  • Article influence score: 0.226
  • Best Quartile: Q3
  • Area: PEDIATRICS Quartile: Q3 Rank in area: 93/128 (Ranking edition: SCIE)

SCImago Journal Rank

  • Year 2019
  • SJR Journal Impact: 0.217
  • Best Quartile: Q3
  • Area: Pediatrics, Perinatology and Child Health Quartile: Q3 Rank in area: 206/333

Scopus CiteScore

  • Year 2019
  • CiteScore of the Journal : 1.1
  • Area: Pediatrics, Perinatology and Child Health Percentile: 36

Journal Citation Indicator (JCI)

  • Year 2019
  • Journal Citation Indicator (JCI): 0.46
  • Best Quartile: Q3
  • Area: PEDIATRICS Quartile: Q3 Rank in area: 116/177

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.