Caracterização das infecções no sistema nervoso central em pacientes pediátricos diagnosticados em um laboratório de referência na cidade de Manaus-Amazonas

Abstract

Introduction: Central nervous system infections are important causes of mortality and morbidity in pediatric patients and are largely related to severe complications such as hearing loss, neurological sequelae, or death. Nonspecific clinical signs usually progress as meningitis, encephalitis, and meningoencephalitis develop. Several etiological agents can cause these infections, among which viruses and bacteria are especially notable. Since neurological infections are a significant concern in the pediatric population, and since there are still gaps in our understanding of pathological and epidemiological aspects in the infant age group, it is essential to deepen research in this area. Objective: The aim of this study was to evaluate the clinical and laboratory profile of pediatric patients diagnosed with central nervous system (CNS) infections in a reference laboratory in Manaus, Amazonas, Brazil. Methodology: This is a cross-sectional, descriptive, and retrospective study that used cerebrospinal fluid samples from pediatric patients with clinical suspicion of central nervous system infection from a hospital network of childcare in Manaus city from 2014 to 2020. The CSF samples were subjected to microbiological, biochemical, and molecular investigation. The Research Ethics Committee approved this study. Results: 766 pediatric patients were considered eligible for the study, the predominant age group being 1 to 4 years and 56% were male. The clinical presentations included fever, vomiting, and a headache. The etiological agent was identified in 117 samples, with bacteria being the main agents, isolated in 72.6% of the cases. The most prevalent infections were Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae type b. Enterovirus, herpesvirus, and arboviruses were the most prevalent viral agents. Conclusion: The overall prevalence of central nervous system infections in the pediatric population of Manaus was 15.4%. 61.9% of the samples were immune-preventable pathogens, while 27.4% were viruses from different families. It is important to have an active laboratory surveillance with sensitive methods capable of identifying, characterizing, and monitoring mainly preventable agents, responsible for a wide range of severe neurological diseases.