Objective: To analyze the characteristics and prognosis of
hearing loss in children with
bacterial meningitis. Methods: This was a single-center retrospective cohort study. Patients diagnosed with
bacterial meningitis who were hospitalized in Beijing Children's Hospital between 2010 and 2016 and older than 28 days and younger than 18 years at symptom onset were included in this study (n=573). All clinical information including hearing assessment results during hospitalization were reviewed. All patients with
hearing loss were followed up to repeat their hearing test and assess their hearing condition with parents' evaluation of aural and (or) oral performance of children (PEACH). Patients were grouped according to their hearing assessment results, and Logistic regression analysis was used to analyze the risk factors for
hearing loss in patients with
bacterial meningitis. Results: Five hundred and seventy-three patients were enrolled in this study, including 347 males and 226 females. The onset age ranged from 29 days to 15.8 years. Two hundred and forty-six patients had identified causative pathogens, among whom 92 cases (37.4%) were
pneumococcal meningitis cases.
Hearing loss was found in 160 cases (27.9%) during hospitalization, involving 240 ears.
Permanent hearing loss was found in 20 cases (16.9%), involving 32 ears. In the patients with
permanent hearing loss, 87.5% (28/32) of ears were identified as severe or profound
hearing loss during hospitalization. Logistic regression analysis showed that
dystonia, the
protein concentration level in cerebrospinal fluid>1 g/
L, glucose concentration level lower than 1 mmol/L and
subdural effusion were independent risk factors for
hearing loss (OR=2.426 (1.450-4.059), 1.865 (1.186-2.932), 1.544 (1.002-2.381) and 1.904 (1.291-2.809)). Conclusions:
Hearing loss is a common sequela of
bacterial meningitis in children. Most patients have transient
hearing loss, but patients with severe or profound
hearing impairment have a higher risk of developing
permanent hearing loss.