{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:42:00Z","timestamp":1747183320065,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare the characteristics, mortality and sequelae at hospital discharge of childhood bacterial meningitis (BM) caused by the three \u201cclassical\u201d agents<jats:italic>Neisseria meningitidis<\/jats:italic>,<jats:italic>Haemophilus influenzae<\/jats:italic>or<jats:italic>Streptococcus pneumoniae<\/jats:italic>versus BM due to other aetiology in Finland, Latin America and Angola.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This observational study is a secondary analysis of data from five prospective treatment trials on non\u2010neonatal BM in Finland, Latin America and Angola in 1984\u20132017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1568 cases, 1459 (93%) were caused by the classics, 80 (5%) by other Gram\u2010negative and 29 (2%) by other Gram\u2010positive bacteria. Nonclassical Gram\u2010negative disease was encountered especially in Angola (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). Overall, children in the nonclassical group presented later for treatment and were more often underweight and anaemic (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In multivariate analysis, even if the area was strongest predictor of poor outcome, nonclassical Gram\u2010negative BM increased the odds for death twofold and the odds for death or severe sequelae 2.5\u2010fold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BM of a nonclassical aetiology is a particularly severe disease affecting especially Angolan children poorly armoured to fight infections. Since vaccinations are diminishing the role of classical agents, that of nonclassical agents is growing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.16357","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T12:12:06Z","timestamp":1649851926000},"page":"1404-1411","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Unusual Gram\u2010negative bacteria cause more severe bacterial meningitis than the three classical agents in children"],"prefix":"10.1111","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-1460","authenticated-orcid":false,"given":"Heikki","family":"Peltola","sequence":"first","affiliation":[{"name":"Pediatrics University of Helsinki Helsinki University Hospital Helsinki 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