Abstract
BackgroundCentral nervous system (CNS) infections are an important cause of childhood morbidity and mortality. The aetiologies of these potentially vaccine-preventable infections have not been well established in Cambodia.MethodsWe did a one year prospective study of children hospitalised with suspected CNS infection at Angkor Hospital for Children, Siem Reap. Cerebrospinal fluid specimens (CSF) samples underwent culture, multiplex PCR and serological analysis to identify a range of bacterial and viral pathogens. Viral metagenomics was performed on a subset of pathogen negative specimens.ResultsBetween 1st October 2014 and 30th September 2015, 284 analysable patients were enrolled. The median patient age was 2.6 years; 62.0% were aged <5 years. CSF white blood cell count was ≥10 cells/μL in 116/272 (42.6%) cases. CNS infection was microbiologically confirmed in 55 children (19.3%). Enteroviruses (21/55), Japanese encephalitis virus (17/55), and Streptococcus pneumoniae (7/55) accounted for 45 (81.8%) of all pathogens identified. Of the pathogens detected, 74.5% (41/55) were viruses and 23.6% (13/55) were bacteria. The majority of patients were treated with ceftriaxone empirically. The case fatality rate was 2.5%.ConclusionsEnteroviruses, JEV and S. pneumoniae are the most frequently detected causes of CNS infection in hospitalised Cambodian children.
Highlights
Central nervous system (CNS) infections are an important cause of childhood morbidity and mortality
The aim of the current study was to provide an update on the aetiologies of CNS infections in Cambodian children aged 1 month to 15 years admitted to a paediatric referral hospital over a one year period. Study site This one-year study was conducted at Angkor Hospital for Children (AHC), a non-governmental hospital located in Siem Reap, Northern Cambodia, and an associated Satellite Clinic (SC) at Sot Nikom District referral hospital, approximately 35 km from Siem Reap
294 (4.8%) children were enrolled into the study and 284 were included in the analyses below (Fig. 1)
Summary
Central nervous system (CNS) infections are an important cause of childhood morbidity and mortality. The aetiologies of these potentially vaccine-preventable infections have not been well established in Cambodia. Meningitis and encephalitis are important causes of mortality and morbidity in children [1, 2]. These central nervous system (CNS) infections frequently result in neuro-developmental sequelae [3, 4]. Data on aetiology are important, since several of the globally important pathogens are at least partially vaccine preventable: Haemophilus influenzae type b (Hib), Neisseria meningitidis, Streptococcus pneumoniae, measles, mumps, rubella, rabies, and Japanese encephalitis virus (JEV) [6,7,8]. There is a paucity of such data for many low and Turner et al BMC Infectious Diseases (2017) 17:806
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