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The burden of pneumococcal meningitis in Austrian children between 2001 and 2008

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Abstract

The present study was conducted to evaluate the burden of pneumococcal meningitis in Austrian children between 2001 and 2008. Clinical outcome was retrospectively analyzed both on discharge and on follow-up investigations. This study was based on a prospective multicentre surveillance study on hospitalized invasive pneumococcal infections in Austrian children with a total annual “study population” of about 399,000 children aged below 5 years per year. Between 2001 and 2008, 74 cases of pneumococcal meningitis were identified in children aged below 5 years. The mean annual incidence rate for pneumococcal meningitis was 2.3 per 100,000 children in this age group. In 57/74 children (mean age on admission 14.5 ± 13.3 months), outcome data on hospital discharge were available: 5 deaths (8.8 %), 20 children (35.1 %) with sequelae and 32 children (56.1 %) without sequelae were observed. Sequelae on discharge included motor impairment in 8 children (14.0 %), hearing impairment in 9 children (15.8 %) and/or other complications in 14 children (24.6 %). In 7/8 children with motor deficits, matching cerebral lesions were identified by neuroimaging: cerebral infarction in five children, cerebral vasculitis and cerebral abscess in one child each. In 40/57 children, long-term outcome (18.9 ± 20.2 months after discharge) could be assessed: 1 child (2.5 %) died 9 months after hospital discharge, 11 children (27.5 %) had one or two long-term sequelae and 28 children (70.0 %) had no sequelae. Long-term sequelae included motor impairment in three children (7.5 %), hearing impairment in nine children (22.5 %) and other deficits in two children (5.0 %). Conclusion: Our study confirms that pneumococcal meningitis causes high mortality and severe long-term sequelae. On long-term follow-up, we observed improvements of motor impairment, but not of hearing impairment.

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Acknowledgments

We would like to thank all paediatricians from all participating hospitals and Pfizer for their support. We also would like to thank Prof. Meinrad Beer for the evaluation of neuroimaging data and Prof. Apostolos Georgopoulos and Prof. Heinz Burgmann for the testing of serotyping.

Conflict of interest

The study was supported by a grant of Pfizer. This grant was used to cover personnel costs. Daniela Klobassa received funding from Pfizer to attend a conference. Werner Zenz accepted fees for lectures and funding to attend conferences from GlaxoSmithKline and Pfizer and was a member of an advisory board of Pfizer in 2011. Bettina Zöhrer received funding from Pfizer to attend a conference. Maria Paulke-Korinek accepted fees for speaking, serving on advisory boards and received funding to attend conferences from GlaxoSmithKline and Pfizer. Herwig Kollaritsch accepted educational grant fees and payment for lectures, for serving on advisory boards and as an independent safety monitor in clinical studies and reimbursement for attending meetings from GlaxoSmithKline and Pfizer. The authors had or have no other relevant affiliations or financial involvement with the subject matter or materials discussed in the manuscript. The role of the sponsor did not influence anyhow this study or the introduction of the vaccine in Austria.

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Authors and Affiliations

  1. Department of General Paediatrics, University Clinic of Paediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria

    D. S. Klobassa, B. Zoehrer, U. Gruber-Sedlmayr, V. Strenger, A. Sonnleitner & W. Zenz

  2. Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria

    M. Paulke-Korinek & H. Kollaritsch

  3. University Clinic of Paediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria

    K. Pfurtscheller

  4. Department of Paediatrics and Adolescent Medicine, General Hospital of Leoben, Leoben, Austria

    R. Kerbl

  5. Department of Paediatrics and Adolescent Medicine, General Hospital of Dornbirn, Dornbirn, Austria

    B. Ausserer

  6. Department of Paediatrics and Adolescent Medicine, Rudolfstiftung Hospital Vienna, Vienna, Austria

    W. Arocker

  7. Department of Paediatrics and Adolescent Medicine, General Hospital of Klagenfurt, Klagenfurt, Austria

    W. Kaulfersch

  8. Department of Paediatrics and Adolescent Medicine, General Hospital of Wiener Neustadt, Wiener Neustadt, Austria

    B. Hausberger

  9. Department of Paediatrics and Adolescent Medicine, Medical University Innsbruck, Innsbruck, Austria

    B. Covi

  10. Department of Paediatrics, Klinikum Wels Grieskirchen, Wels, Austria

    F. Eitelberger

  11. St. Anna Children’s Hospital, Department of Paediatrics, Medical University Vienna, Vienna, Austria

    A. Vécsei

  12. Department of Paediatrics, Academic Teaching Hospital Feldkirch, Feldkirch, Austria

    B. Simma

  13. Department of Paediatrics and Adolescent Medicine, General Hospital of Villach, Villach, Austria

    R. Birnbacher

  14. Department of Paediatrics and Adolescent Medicine, Danube Hospital, Vienna, Austria

    H. Kurz

  15. Department of Paediatric and Adolescent Medicine, Clinicum St. Pölten, St. Pölten, Austria

    K. Zwiauer

  16. Department of Paediatrics, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria

    D. Weghuber

  17. Austrian Agency for Health and Food Safety, Graz, Austria

    S. Heuberger

  18. Institute of Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria

    F. Quehenberger

  19. Research Unit Infectiology and Vaccinology, Department of General Paediatrics, Medical University Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria

    W. Zenz

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  1. D. S. Klobassa
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  2. B. Zoehrer
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  19. K. Zwiauer
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  20. D. Weghuber
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  21. S. Heuberger
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  22. F. Quehenberger
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  23. H. Kollaritsch
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  24. W. Zenz
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Corresponding author

Correspondence to W. Zenz.

Additional information

Communicated by Prof. D. Nadal

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Table 2

Cerebral lesions with focal neurological deficits as complication of pneumococcal meningitis (PDF 14 kb)

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Klobassa, D.S., Zoehrer, B., Paulke-Korinek, M. et al. The burden of pneumococcal meningitis in Austrian children between 2001 and 2008. Eur J Pediatr 173, 871–878 (2014). https://doi.org/10.1007/s00431-013-2260-8

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  • DOI: https://doi.org/10.1007/s00431-013-2260-8

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