Please cite this article in press as: Jordan I, et al. Clinical, biochemical and microbiological factors associated with the prognosis of pneumococcal meningitis in children. Enferm Infecc Microbiol Clin. 2015. http://dx.doi.org/10.1016/j.eimc.2015.03.004 ARTICLE IN PRESS G Model EIMC-1310; No. of Pages 7 Enferm Infecc Microbiol Clin. 2015;xxx(xx):xxx–xxx www.elsevier.es/eimc Original article Clinical, biochemical and microbiological factors associated with the prognosis of pneumococcal meningitis in children Iolanda Jordan a,∗ , Yolanda Calzada a , Laura Monfort b , David Vila-Pérez a , Aida Felipe a , Jessica Ortiz b , Francisco José Cambra a , Carmen Mu˜ noz-Almagro c a Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain b Pediatric Service, Hospital de Sant Joan de Déu, Barcelona, Spain c Molecular Microbiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain a r t i c l e i n f o Article history: Received 27 November 2014 Accepted 2 March 2015 Available online xxx Keywords: Prognosis Pneumococcal meningitis Pediatrics a b s t r a c t Background: Pneumococcal meningitis (PM) has a high morbidity and mortality. The aim of the study was to evaluate what factors are related to a poor PM prognosis. Methods: Prospective observational study conducted on patients admitted to the Pediatric Intensive Care Unit in a tertiary hospital with a diagnosis of PM (January 2000 to December 2013). Clinical, biochemical and microbiological data were recorded. Variable outcome was classified into good or poor (neurological handicap or death). A multivariate logistic regression was performed based on the univariate analysis of significant data. Results: A total of 88 patients were included. Clinical variables statistically significant for a poor outcome were younger age (p = .008), lengthy fever (p = .016), sepsis (p = .010), lower Glasgow Score (p < .001), higher score on Pediatric Risk Mortality Score (p = 0.010) and Sequential Organ Failure Assessment (SOFA) (p < .001), longer mechanical ventilation (p = .004), and inotropic support (p = .008) requirements. Statisti- cally significant biochemical variables were higher level of C-reactive protein (p < .001) and procalcitonin (p = .014) at admission, low cerebrospinal (CSF) pleocytosis (p = .003), higher level of protein in CSF (p = .031), and severe hypoglycorrhachia (p = .002). In multivariate analysis, independent indicators of poor outcome were age less than 2 years (p = .011), high score on SOFA (p = .030), low Glasgow Score (p = .042), and severe hypoglycorrhachia (p = .009). Conclusions: Patients younger than 2 years of age, with depressed consciousness at admission, especially when longer mechanical ventilation is required, are at high risk of a poor outcome. © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved. Factores clínicos, bioquímicos y microbiológicos relacionados con el pronóstico de la meningitis neumocócica en ni˜ nos Palabras clave: Pronóstico Meningitis neumocócicas Pediatría r e s u m e n Introducción: Las meningitis neumocócicas (MN) se relacionan con una elevada morbimortalidad. El objetivo del estudio es evaluar qué factores se relacionan con un peor pronóstico. Métodos: Estudio prospectivo observacional con pacientes diagnosticados de MN ingresados en la Unidad de Cuidados Intensivos Pediátricos de un hospital de tercer nivel (enero 2000-diciembre 2013). El pronós- tico fue clasificado en buena o mala evolución (secuelas neurológicas o muerte). Se realizó un análisis multivariante de los resultados significativos obtenidos en el análisis univariante. ∗ Corresponding author. E-mail address: ijordan@hsjdbcn.org (I. Jordan). http://dx.doi.org/10.1016/j.eimc.2015.03.004 0213-005X/© 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.