Meningococcal Disease Admissions in a Paediatric Intensive Care Unit

Authors

  • Patrícia Mação Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Gustavo Januário Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Sofia Ferreira Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Andrea Dias Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Teresa Dionísio Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Carla Pinto Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Leonor Carvalho Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

DOI:

https://doi.org/10.20344/amp.4073

Abstract

Introduction: Meningococcal infection has a high mortality and morbidity in children. Aggressive initial shock approach, early referral, secondary transport and vaccination are potential factors with impact in reducing its mortality. Objectives were to characterize children admitted to intensive care due to invasive meningococcal disease, to evaluate their prognostic scores and mortality.
Material and Methods: Observational study, with retrospective data collection. Two periods were created according to the year of admission (A: 2000-2005 and B: 2006-2011). Prognostic parameters, organ failure and mortality rates were compared in these groups.
Results: 70 children were admitted with invasive meningococcal disease. When compared with other causes of admission, a decrease in the number of admissions due to invasive meningococcal disease was observed (period A: 3.4%; period B: 1.5%; p = 0.001). The presence of meningitis was 41% in period A and 29% in period B (p = 0.461). Rapidly progressive purpura occurred in 78% in period A and 50% in period B (p = 0.032). Children from period A had multi-organ failure (80%), disseminated intravascular coagulation (76%) and coma (22%) more frequently than children from period B (29%, 29%, 0%; p < 0.05). Mortality was 26% in period A and 0% in period B (p = 0.006) and standardized mortality by PRISM was 1.3 and 0 in period A and B respectively.
Discussion: The decrease in the number of admissions due to invasive meningococcal disease can be explained by the introduction of anti-meningococcal C vaccine in 2006. Mortality decline can be possibly explained by an improvement in the initial patient stabilization and to secondary transport.
Conclusion: A decrease in the number of admissions due to invasive meningococcal disease and in mortality was observed.
Keywords: Child; Infant; Intensive Care Units, Pediatric; Meningococcal Infections; Multiple Organ Failure; Mortality; Portugal; Sepsis.

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Author Biographies

Patrícia Mação, Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Gustavo Januário, Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Sofia Ferreira, Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Andrea Dias, Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Teresa Dionísio, Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Carla Pinto, Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Leonor Carvalho, Serviço de Cuidados Intensivos. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Published

2014-06-30

How to Cite

1.
Mação P, Januário G, Ferreira S, Dias A, Dionísio T, Pinto C, Carvalho L. Meningococcal Disease Admissions in a Paediatric Intensive Care Unit. Acta Med Port [Internet]. 2014 Jun. 30 [cited 2024 Mar. 28];27(3):291-4. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/4073

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Original