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Vol. 12, Art. 10 (pp. 105-128)    |    jan 2011       

№ гос. регистрации: 0421100002\0010

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Mathematical modeling of the early individual forecast at a bacterial purulent meningitis

V.V. Pilipenko¹, Yu.V. Lobzin², M.V. Rezvantsev³

1-St-Petersburg Medical Academy of Postgraduate Studies, Saint-Petersburg
2- Medical Research Institute for Children’s Infections FMBA Russia, Saint-Petersburg
3- Military Medical Academy n.a. S.M. Kirov, Saint-Petersburg

Brief summary

On the basis of the studying of clinical and laboratory sings of 150 cases of bacterial purulent meningitis (BM) with the use of main components method and multivariate logistical regression analysis, the early prognostic criteria of the maximum risk and the relation of chances of the maximum risk of an acyclic (severe, complicated, including lethal) variant of a diseases were estimated as the most informative: age of the patient, late hospitalisation, the expressed disturbances of consciousness (coma), episodes of generalized cramps in acute period, presence of \\\"focal\\\" neurologic sings, also the CSF protein level and factor size «glucose CSF level/glucose serum level» at primary (diagnostic) Lp. Using of an offered mathematical models allows to prognosticate an aciclic variant of BM with efficiency of 92 %, at specificity of 90,6 % and sensitivity of 93 % in some hours after getting to the hospital.


Key words

bacterial meningitis, diagnostics, prognostic risk factors, early prognosis, individual mathematical model of bacterial meningitis early prognosis.

Reference list

1. Pokrovskii V.I. Infekcionnie bolezni i epidemiologiya / V.I. Pokrovskii, S.G. Pak, N.I. Briko, B.K. Danilkin – M.: GEOTAR-Media, 2007. – 816 s.


2. Koroleva I.S. Meningokokkovaya infekciya i gnoinie bakterialnie meningiti: ryk. po laboratornoi diagnostike / I.S. Koroleva, G.V. Beloshickii; pod red. V.I. Pokrovskogo. – M: OOO «Medicinskoe informacionnoe agentstvo», 2007. – 112 s.


3. Ushyk N.D. Lekcii po infekcionnim boleznyam / N.D. Ushyk, U.Ya. Vengerov // Meningokokkovaya infekciya. – M.: Medicina, 2007. – S.466–480.


4. Sorokina M.N. Bakterialnie meningiti y detei / M.N. Sorokina, V.V. Ivanova, N.V. Skripchenko. – M: Medicina, 2003. – 320 s.


5. Lobzin U.V. Meningiti i meningoencefaliti / U.V. Lobzin, V.V. Pilipenko, U.A. Gromiko. – SPb: OOO «Izdatelstvo FOLIANT», 2003. – 128 s.


6. Arda B. Pooled analysis of 2,408 cases of acute adult purulent meningitis from Turkey / B. Arda, O.R. Sipahi, S. Atalay // Med. Princ. Pract. – 2008. – Vol. 17 (1). – P. 76–79.


7. Khwannimit B . Acute bacterial meningitis in adults: a 20 year review / Khwannimit B., P. Chayakul, A. Geater // Southeast Asian J. Trop. Med. Public Health. – 2004. – Vol. 35, № 4. – P.886 – 892.


8. Nudelman Y. Bacterial meningitis: epidemiology, pathogenesis and management update / Y. Nudelman, A.R. Tunkel // Drugs. – 2009. – Vol. 69, № 18. – P. 2577–2596.


9. Worsøe L. Factors associated with the occurrence of hearing loss after pneumococcal meningitis / L. Worsøe, P. Cayé-Thomasen, C.T. Brandt // Clin. Infect. Dis. – 2010. – Vol. 51, № 8. – P. 917–924.


10. Korsholm J . Sequelae and death following pneumococcal meningitis / J. Korsholm, R.N. Kristensen, A. Heslop // Ugeskr Laeger. – 2009. – Vol. 171, № 18. – P. 1481– 1485.


11. Miranda J . Strategies and new developments in the management of bacterial meningitis / J. Miranda, A.R. Tunkel // Infect. Dis. Clin. North. Am. – 2009. – Vol. 23, № 4. – P. 925–943.


12. Hussein A.S . Acute bacterial meningitis in adults. A 12-year review / A.S. Hussein, S.D. Shafran // Medicine (Baltimore). – 2000. – Vol. 79, № 6. – P. 360–368.


13. Cinzerling V.A. Infekcionnie porajeniya nervnoi sistemi: voprosi etiologii, patogeneza i diagnostiki / V.A. Cinzerling, M.L. Chyhlovina. – SPb: «ELBI- SPb», 2005. – 448 s.


14. Manga N.M. Adult purulent meningitis caused by Streptococcus pneumoniae in Dakar, Senegal / N.M. Manga, S.A. Diop, R. Ka-Sall // Med. Trop. – 2008. – Vol. 68, № 6. – P. 625–628.


15. Kastenbauer S . Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases / S. Kastenbauer, H.W. Pfister // Brain. – 2003. – Vol. 126, Pt. 5. – P. 1015–1025.


16. Lala H.M. Meningococcal disease deaths and the frequency of antibiotic administration delays / H.M. Lala, G.D. Mills, K. Barratt // J. Infect. 2007. – Vol. 54. – P. 551– 557.


17. Stephens D.S . Epidemic meningitis, meningococcaemia, and Neisseria meningitides / D.S. Stephens, B. Greenwood, P. Brandtzaeg // Lancet. – 2007. – Vol. 369, № 9580. – P. 2196–2210.


18. Aleksandrova I.A. Prakticheskie podhodi k lecheniu bakterialnih meningitov / I.A. Aleksandrova, V.B. Beloborodov, U.V. Lobzin // Antibiotiki i himioterapiya. – 2007. – T.52, №3. – S.3–21.


19. Rebrova O.U. Statisticheskii analiz medicinskih dannih. Primenenie paketa prikladnih programm STATISTICA / O.U. Rebrova. – M.: Media Sfera, 2003. – 305 s.


20. Unkerov V.I. Matematiko-statisticheskaya obrabotka dannih medicinskih issledovanii / V.I. Unkerov, S.G. Grigorev, M.V. Rezvancev. – 3-e izd., dop. – SPb.: VMedA, 2011. – 318 s.


21. Zayavka 067336 Rossiiskaya Federaciya, MPK7 A61V 5/04,A61V 5/00. Sposob prognozirovaniya techeniya bakterialnih gnoinih meningitov / U.V. Lobzin, V.V. Pilipenko, M.V. Rezvancev, A.M. Alekseev; zayavitel Federalnoe gosydarstvennoe ychrejdenie Naychno-issledovatelskii instityt detskih infekcii Federalnogo mediko-biologicheskogo agentstva; pat. poverennii N.A. Dobroskok. - №2010146608/14(067336); zayavl.16.11.2010, №2010146608. – 13 s.: il.


22. Lu S.H. Community-acquired bacterial meningitis in adults: the epidemiology , timing of appropriate antimicrobial therapy, and prognostic factors / S.H. Lu, S.R. Huang, W.N. Chang // Clin. Neurol. Neurosurg. – 2002. – Vol. 104. – P. 352–358.


23. Van de Beek D . Clinical features and prognostic factors in adults with bacterial meningitis / D. Van de Beek, J. de Gans J, Spanjaard L . // N. Engl. J. Med. – 2004. – Vol. 351, № 18. – P. 1849–1859.


24. Practice guidelines for acute bacterial meningitidis (except newborn and nosocomial meningitis) /17th Consensus Conference on anti-infective chemotherapy. - Paris, 2008. – 18 p. - [Elektronnii resyrs]. – Elektron. dan. – Rejim dostypa: http: //www.infectologie.com/site/medias/english/meningitiseuibis.org/, svobodnii. – Zagl. s ekrana.


25. Ivanov K.S. Meningokokkovaya infekciya y lic molodogo vozrasta: Klinika, diagnostika, lechenie: avtoref. dis. ... d-ra med. nayk / K.S. Ivanov. – L., 1982. – 30 s.


26. Weisfelt M . Community-acquired bacterial meningitis in older people / M. Weisfelt, D. van de Beek, L. Spanjaard // J. Am. Geriatr. Soc. – 2007. – Vol. 55, № 4. – P. 628–629.


27. Hoen B. Mortality in pneumococcal meningitis: a multivariate analysis of prognostic factors / B. Hoen, J.F. Viel, A. Gerard // Eur. J. Med. – 1993. – Vol. 2, № 1. – P.28– 32.


28. Tunkel A.R. Cerebrospinal fluid shunt infections / A.R. Tunkel, B.A. Kaufman // (eds.) G. L.Mandell, J. E. Bennett, R. Dolin // Principles and Practice of Infectious Diseases; – 6th ed. – Philadelphia, 2005. – P. 1126–1132.


29. Weisfelt M. Community-acquired bacterial meningitis in alcoholic patients / M. Weisfelt, J. de Gans, A. van der Ende et al. // PLoS One. – 2010. – Vol . 5 (2). – e 9102. [Elektronnii resyrs]. – Elektron. dan. – Rejim dostypa: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817003/?tool=pubmed/, svobodnii. – Zagl. s ekrana.

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