Investigations On Prevalence And Related Factors Of Hearing Loss In Patients With Bacterial Meningitis

Objective:To investigation the prevalence and clinical characteristics of hearing loss in Bacterial Meningitis (BM) patients, and analyse the potential influencing factors associated with the hearing loss.Methods:Collected172cases of bacterial meningitis in hospitalized patients from the First Affiliated Hospital of Guangxi Medical University from January2007to January2012, of which78cases were evaluated by pure tone audiometry (PTA)、 auditory brainstem responses (ABR)、tympanogram、 Stapedius acoustic reflex, according to these results,78patients with bacterial meningitis are divided into groups of hearing loss and not hearing loss.56Volunteer without bacterial meningitis were evaluated by PTA or ABR as control group. The influencing factors for hearing impairment in patients with bacterial meningitis were analyzed by univariate analysis and multivariate logistic regression analysis.Results:(1) The hearing loss were observed31of78(39.7%) in BM patients compared with4of56(7.1%) controls (P<0.05). Adult BM patients (greater than18year of age) had a statistically significantly higher rate of hearing loss than did children less than18years of age (56.8%[21/37] vs 24.4%[10/41], P<0.05).(2) Sensorineural hearing loss (SNHL) occurred in83.9%(26/31) BM patients. Bilateral hearing loss occurred in80.6%(25/31) BM patients. Bilateral severe hearing loss occurred in41.9%(13/31) BM patients. Bilateral profound hearing loss occurred in19.4%(6/31) BM patients. Permanent hearing loss occurred in83.9%(26/31) BM patients.(3)The univariate analysis shows meningeal irritation signs positive (OR=3.938、 CSF sugar<1.0mmol/L (OR=6.224)、serum of CRP>20mg/L (OR=4.667)、 age>18years (OR=4.069) is risk factors of BM hearing loss(P<0.05), The use of hormones (B=-1.342, OR=0.261)、 the use of mannitol (B=-1.042, OR=0.353)is protective factors of BM hearing loss; Logistic regression analysis showed that meningeal irritation signs positive (P=0.003, OR=12.454)、 CSF sugar<1.0mmol/L (P=0.030, OR=8.322) is risk factors of BM hearing loss.Conclusion:1、 Hearing loss with BM patients has higher prevalence(39.7%).2、 The majority of bacterial meningitis hearing loss is SNHL、 bilateral hearing loss、 bilateral severe hearing loss、 bilateral profound hearing loss、 permanent hearing loss.3、 Meningeal irritation signs positive、 CSF sugar<1.0mmol/L、 serum of CRP>20mg/L、 age>18years is risk factors of BM hearing loss, The use of hormones、 the use of mannitol is protective factors of BM hearing loss; Logistic regression analysis showed that meningeal irritation signs positive、 CSF sugar<1.0mmol/Lis risk factors of BM hearing loss.