Epidemiology Of Bacterial Meningitis Research Articles

Fifteen years of experience with bacterial meningitis.

Introduction of Haemophilus influenzae type b (Hib) vaccines has dramatically altered the epidemiology of bacterial meningitis in children. The goal of this study was to describe these changes in a pediatric teaching hospital. Patient charts at Children's Hospital and Regional Medical Center, Seattle, were identified by diagnosis codes and reviewed retrospectively. The 1981 to 1995 time period was chosen to incorporate three distinct 5-year periods: before the use of unconjugated Hib vaccine; between the unconjugated and conjugate vaccines; and after the conjugate vaccines were available for routine immunization of infants. Bacterial meningitis was identified in 806 cases. In 13 premature infant cases Escherichia coli was most frequently isolated (6 cases). Group B Streptococcus, E. coli and Listeria monocytogenes were the most common pathogens in 87 neonatal cases. The most common pathogens in 706 cases of childhood meningitis were H. influenzae, Streptococcus pneumoniae and Neisseria meningitidis. H. influenzae was the most common pathogen in the first two time periods (73 and 69% of childhood cases, respectively), but not so in the third period (16%). A changing pattern in childhood meningitis was observed during the study period. H. influenzae cases dramatically declined, altering the relative proportions of other pathogens, S. pneumoniae and N. meningitidis. However, the number of cases caused by these latter pathogens remained steady.

Need for Haemophilus influenzae type b vaccination in Asia as evidenced by epidemiology of bacterial meningitis.

To evaluate the role of Haemophilus influenzae type b (Hib) infections in Asia by scrutinizing data on Hib meningitis. A comprehensive literature search was performed in English and other languages. Special attention was paid to the age group of 0 to 4 years, in which the great majority of Hib meningitis occurs. Twenty studies from as many countries indicated Hib to be a major pathogen in childhood meningitis. In series comprising nearly 2000 patients, Hib was responsible for at least 50% of cases in one-third of series and for at least 25% in three-fourths of series investigated and was the leading pathogen overall. The countries in South and Southeast Asia differed from the Middle East and East Asia in having a greater incidence of meningitis during the first 6 months of life; the proportions were 50 to 60% vs. 10 to 30%, respectively (P < 0.001). Despite lacking data from many areas, belief in a paucity of Hib disease in Asia is not supported by the existing data; and because meningitis represents only 50 to 75% of all classical Hib manifestations and some cases occur after the age of 4 years, vaccination is warranted. The cumulative age curves suggest that conjugates with good immunogenic potential should be used, especially in South and Southeast Asia.

The Changing Epidemiology of Bacterial Meningitis: Implications for the Clinical Laboratory

The Changing Epidemiology of Bacterial Meningitis: Implications for the Clinical Laboratory

Bacterial meningitis in the pediatric population: paradigm shifts and ramifications for otolaryngology-head and neck surgery

Various population-based studies have suggested that the incidence and epidemiology of bacterial meningitis is changing. No studies have been published which examine a sample population of the United States at large. Records of pediatric patients age 5 and under who were treated for bacterial meningitis ( n = 470) at all US Army medical facilities between 1986 and 1991 were reviewed. The incidence of bacterial meningitis declined by 75% in the study group during this period. The largest decrease occurred in infants less than 1 year of age. The bacterial organisms isolated most commonly, in decreasing frequency were: Haemophilus influenza type b (HIB), pneumococcal, streptococcal, and staphylococcal. The most dramatic abatement occurred in Haemophilus meningitis following the introduction of HIB vaccinations. Neurologic sequelae were identified in 10% of meningitis survivors. The 2 most common impairments were hearing loss and speech/language delay. Economic modeling demonstrates tremendous savings in health care dollars from the decrease in disease incidence. These changes will have substantial bearing on training programs and practitioners, since the management of neurologic sequelae requires the expertise of multiple subspecialists. In the face of a medical onslaught, once devastating diseases are in retreat.

Bacterial meningitis

In this review the epidemiology of bacterial meningitis and the new insights in the pathophysiology are thoroughly discussed. The different diagnostic steps are described and the present day antibiotic strategy and adjunctive inflammation-modulating therapy are delineated.

The epidemiology of bacterial meningitis.

The incidence by age and causative organism of bacterial meningitis are not known on a community basis. The epidemiology of bacterial meningitis in a metropolitan county was studied by identifying all cases admitted to a hospital from 1983 through 1987. The overall incidence of bacterial meningitis was 5 per 100,000 person-years, but numbers of cases ranged from 40 per 100,000 for children younger than 5 years to 1.0 per 100,000 in adults aged between 16 and 64 years. No significant excesses of cases were found in male patients or in blacks. The predominant causative organism varied with age. Overall, Haemophilus influenzae was the most common causative organism, but 32 percent of cases were due to Streptococcus pneumoniae. Case fatality rates were high for S. pneumoniae (12.5 percent) and very high for the small number of elderly patients suffering from bacterial meningitis. Significant declines have occurred in the last decade in the incidence of bacterial meningitis in children, particularly in those younger than 5 years, and in disease caused by H. influenzae and group B streptococcus.

A study of 280 cases of neonatal meningitis in The Netherlands

Within the framework of a more extensive study of the epidemiology of bacterial meningitis in The Netherlands (1976-1982), 280 cases of neonatal meningitis were investigated retrospectively. Escherichia coli (132 cases, 47%), Streptococcus agalactiae (68 cases, 24%), Listeria monocytogenes (12 cases, 4%) were the organisms most commonly isolated. The mortality rate for these 280 cases was 27%. The male-female ratio was 1.33:1. The minimum incidence for The Netherlands was calculated to be 23 per 100 000 live births.