Objective Meningitis is one of the most common causes of acquired sensorineural hearing loss in childhood. The aim of this study was to identify parameters predicting long-term audiological complications in meningitis.

Methods Patients under 18 years admitted to the Bambino Gesù Pediatric Hospital between March 2001 and February 2019 with a diagnosis of meningitis entered the study. Audiological complications had been investigated during hospitalization and at follow-up.

Results During the study period, 425 patients were enrolled. Sensorineural hearing loss was observed in 48 patients (11.3%). Multivariate analysis has shown that female gender predisposes to the development of permanent hearing loss after meningitis. Hearing impairment was associated with pneumococcal etiology (p < 0.001), lethargy (p = 0.027), reduced cerebrospinal fluid glucose level (26.18 mg/dL, p = 0.004), increase in both C-reactive protein (17.77 mg/dL, p = 0.001), and erythrocyte sedimentation rate (106.3 mm/h, p = 0.004). At follow-up, 19 patients had a persisting hearing damage, 7 recovered their hearing capacity and 20 were lost to follow-up. Among patients with permanent hearing damage, treatment was necessary in 16 patients. In details, 6 patients required external hearing aids and 10 patients required a cochlear implant.

Conclusions Female gender, lethargy at onset, reduced cerebrospinal fluid glucose level, increased inflammation index, and pneumococcal etiology are correlated with sensorineural hearing damage in meningitis patients.

目的 脑膜炎是儿童获得性感音神经性听力损失的最常见原因之一。本研究的目的是确定预测脑膜炎长期听力学并发症的参数。

方法 2001 年 3 月至 2019 年 2 月期间在 Bambino Gesù 儿科医院住院并诊断为脑膜炎的 18 岁以下患者进入研究。在住院期间和随访期间对听力学并发症进行了调查。

结果 在研究期间，共招募了 425 名患者。在 48 名患者 (11.3%) 中观察到感音神经性听力损失。多变量分析表明，女性更容易在脑膜炎后发展为永久性听力损失。听力障碍与肺炎球菌病因 ( p  < 0.001)、嗜睡 ( p  = 0.027)、脑脊液葡萄糖水平降低 (26.18 mg/dL, p  = 0.004)、C 反应蛋白增加 (17.77 mg/dL, p  = 0.001) 和红细胞沉降率 (106.3 mm/h, p = 0.004）。随访时，19 名患者听力持续受损，7 名恢复听力，20 名失访。在永久性听力损伤的患者中，有 16 名患者需要治疗。具体而言，6 名患者需要外置助听器，10 名患者需要人工耳蜗。

结论 女性、发病时嗜睡、脑脊液葡萄糖水平降低、炎症指数升高、肺炎球菌病因与脑膜炎患者感音神经性听力损伤有关。