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首页> 外文期刊>Expert review of anti-infective therapy >Treatment and prevention strategies to combat pediatric pneumococcal meningitis.
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Treatment and prevention strategies to combat pediatric pneumococcal meningitis.

机译：防治小儿肺炎球菌性脑膜炎的治疗和预防策略。

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Pneumococcal meningitis is a severe, life-threatening infection of the nervous system affecting infants, children and adults alike. The incidence of pneumococcal meningitis in infants and children less than 2 years of age in Europe is approximately 10 out of 100,000 per year, rising to approximately 148 out of 100,000 per year in Gambian infants. The use of highly sensitive tests such as PCR may increase the likelihood of detecting the infection by 20% or more. Epidemics of serotype 1 pneumococcal meningitis in northern Ghana, have had many of the characteristics of meningococcal meningitis epidemics. Neurologic sequelae may occur in 28-63% of cases, and serotype 3 is associated with a 2.54 relative risk of death. The pathogenic process can be divided into invasion, inflammatory pathways, bacterial toxicity and damage; pneumolysin being particularly associated with apoptosis. In the future, neuroprotection may be achieved, targeting this process at all these levels. Therapeutic guidelines have been published by the Infectious Diseases Society of America. Standard empiric therapy, in those aged greater than or equal to 1 month, is a third-generation cephalosporin plus vancomycin. There is insufficient evidence relating to the use or otherwise of corticosteroids in pneumococcal meningitis to make a firm recommendation. The advent of a pneumococcal conjugate vaccine is the most powerful tool available for the prevention of pneumococcal meningitis in all parts of the world.
机译：肺炎球菌性脑膜炎是严重的威胁生命的神经系统感染，影响婴儿，儿童和成人。在欧洲，婴儿和2岁以下儿童中的肺炎球菌性脑膜炎的发病率约为每年100,000人中的10人，而冈比亚婴儿中每年约有100,000人中的148人。使用高度敏感的检测（例如PCR）可能会使检测到感染的可能性增加20％或更多。在加纳北部，血清型1肺炎球菌性脑膜炎的流行具有脑膜炎球菌性脑膜炎的许多特征。神经系统后遗症可能发生在28-63％的病例中，血清型3与2.54的相对死亡风险相关。致病过程可分为入侵，炎症途径，细菌毒性和破坏。肺炎球菌溶血素特别与细胞凋亡有关。将来，可以在所有这些水平上针对这一过程实现神经保护。治疗指南已由美国传染病学会出版。对于年龄大于或等于1个月的患者，标准的经验疗法是第三代头孢菌素加万古霉素。没有足够的证据证明在肺炎球菌性脑膜炎中使用或不使用皮质类固醇有力推荐。肺炎球菌结合疫苗的问世是可用于预防世界各地肺炎球菌脑膜炎的最强大工具。

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