Clinical Features and Imaging Abnormalities of <i>Escherichia coli</i> Meningitis: A Nationwide Multicenter Study

This study aimed to investigate the clinical features of <i>Escherichia coli</i> (<i>E coli</i>)-induced pediatric pyogenic meningitis and analyze the risk factors for imaging abnormalities. These findings provide evidence for early diagnosis and treatment to improve patient prognosis. A multicenter retrospective study was conducted, which included 321 confirmed cases of <i>E coli</i> meningitis. A total of 98.8% (317/321) of the patients had an age at onset of 1 year or younger. Imaging abnormalities were observed in 63.5% (202/318) of the patients and primarily included subdural effusion and/or abscess (28.9%), hydrocephalus or ventricular dilation (21.4%), and intracranial hemorrhage (18.9%). Multivariate logistic regression analysis revealed that initial cerebrospinal fluid (CSF) glucose concentration (odds ratio [OR] = 0.758, 95% confidence interval [CI] = 0.601-0.956, <i>P =</i> .019) and neurological symptom duration exceeding 1 week were independent risk factors for imaging abnormalities. Cerebrospinal fluid glucose levels and the duration of neurological symptoms are crucial indicators for assessing disease severity.