INTRODUCTION Acute bacterial meningitis (ABM) is a serious infectious disease and medical emergency. Given the fact of its high mortality and morbidity, detecting prognostic factors is potentially useful in improving treatment strategies. This paper aims to determine prognostic factors of short-term outcomes of patients with ABM in a developing country - Bosnia and Herzegovina, measured by the Modified Rankin Scale (MRS) at discharge. METHODOLOGY In this retrospective cohort study, 56 patients treated at the Clinic of Infectious Diseases, Clinical Center University of Sarajevo, for 11 years (2012-2022) were included. Statistical analysis was performed using IBM SPSS Statistics version 29.0.1.0. RESULTS The subjects' average age was 31.6 ± 27.7 years, with the youngest patient being 4 months and the oldest 75 years old. Among those, 31 were male and 25 were female. Unfavorable outcomes had 16 (28.6%) patients, including fatal outcomes in four patients and severe disabilities in 12 patients (MRS: 2-6), while 40 (71.4%) patients had favorable outcomes (MRS: 0-1). In the multivariate analysis, predictors of unfavorable outcomes included age older than 60 years, duration of symptoms longer than 24 hours, presence of neurological defects at admission, impaired consciousness, respiratory distress, and no corticosteroid use during treatment. CONCLUSIONS There is certainly a window of opportunity for patients with ABM: The shorter the time between disease onset and treatment initiation, the better the disease outcome.

Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory autoimmune disease in childhood, significantly contributing to both short- and long-term disability. While certain human leukocyte antigen (HLA) class II alleles are known to be associated with specific subgroups of JIA, emerging evidence suggests a strong correlation between these alleles and treatment response. This study involved 143 JIA patients diagnosed according to International League of Associations for Rheumatology criteria. Each patient underwent HLA class II typing, including HLA-B27, as well as tests for rheumatoid factor (RF) and antinuclear antibodies (ANA). Comprehensive rheumatological assessments were conducted at diagnosis, with follow-ups at three and six months post-onset. After six months of methotrexate (MTX) treatment, patients were categorized as responders or non-responders. Responders achieved clinically inactive disease based on the American College of Rheumatology Provisional Criteria for Defining Clinical Inactive Disease and Clinical Remission. Non-responders, who did not reach clinically inactive disease after six months of treatment, required the addition of another non-biological disease-modifying antirheumatic drug (DMARD) or a biological DMARD. Our analysis revealed that the HLA-DRB1*01 allele is a significant prognostic marker for therapeutic response, predicting therapeutic resistance (P ═ 0.01). The most prevalent HLA-DRB1 alleles in the treatment-resistant group were HLA-DRB1*08:11 (11.3%), HLA-DRB1*01:01 (8.5%), HLA-DRB1*01:13, HLA-DRB1*04:11 (7%), HLA-DRB1*08:13, and HLA-DRB1*08:15 (4.2%). These findings highlight the critical role of HLA class II alleles in pediatric rheumatology, particularly in relation to treatment response and disease prognosis. In the era of personalized medicine, understanding the genetic contributions to treatment response and outcomes in JIA patients is essential. A key limitation of this study was the lack of comparison of treatment responses across different JIA subtypes. Future studies should prioritize evaluating MTX efficacy within specific JIA subgroups to enable a more tailored understanding of its effectiveness.