Changing epidemiology of bacterial meningitis

Dery, Mark Alain; Hasbun, Rodrigo

doi:10.1007/s11908-007-0047-7

Cited by 57 publications

(35 citation statements)

References 46 publications

(63 reference statements)

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“…With the introduction of H. influenzae type b conjugate vaccines in the United States and several countries throughout the world, the epidemiology of bacterial meningitis dramatically changed (88). In a subsequent study conducted by the CDC in 1995 in laboratories serving all of the acute-care hospitals in 22 counties of four states (Georgia, Tennessee, Maryland, and California) that served more than 10 million people, the incidence of bacterial meningitis dramatically declined as a direct result of the vaccine-related decline in cases caused by H. influenzae type b (281); the incidence of the other etiological agents had little or no change compared with the 1986 data.…”

Section: Epidemiology and Vaccinationmentioning

confidence: 99%

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

2010

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SUMMARY The epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations at risk to ascertain public health measures and ensure appropriate management. In this review, we describe the changing epidemiology of bacterial meningitis in the United States and throughout the world by reviewing the global changes in etiological agents followed by specific microorganism data on the impact of the development and widespread use of conjugate vaccines. We provide recommendations for empirical antimicrobial and adjunctive treatments for clinical subgroups and review available laboratory methods in making the etiological diagnosis of bacterial meningitis. Finally, we summarize risk factors, clinical features, and microbiological diagnostics for the specific bacteria causing this disease.

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Section: Epidemiology and Vaccinationmentioning

confidence: 99%

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

2010

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“…It is the commonest cause of bacterial meningitis in the USA and many countries worldwide (2,3). Despite effective antimicrobial therapy, pneumococcal meningitis remains highly lethal and has substantial long-term sequelae (4,5). The availability and use of pneumococcal conjugate vaccines has decreased the incidence of invasive diseases caused by serotypes included in the vaccine formulation.…”

Section: Introductionmentioning

confidence: 99%

Identification of a novel pneumococcal vaccine antigen preferentially expressed during meningitis in mice

et al. 2012

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Streptococcus pneumoniae is the most common cause of severe bacterial meningitis in children, the elderly, and immunocompromised individuals. To identify virulence factors preferentially expressed during meningitis, we conducted niche-specific genome-wide in vivo transcriptomic analysis after intranasal infection of mice with serotype 4 or 6A pneumococci. The expression of 34 bacterial genes was substantially altered in brain tissue of mice infected with either of the 2 strains. Ten upregulated genes were common to both strains, 7 of which were evaluated for their role in the development of meningitis. One previously uncharacterized protein, α-glycerophosphate oxidase (GlpO), was cytotoxic for human brain microvascular endothelial cells (HBMECs) via generation of H 2 O 2 . A glpO deletion mutant was defective in adherence to HBMECs in vitro as well as in progression from the blood to the brain in vivo. Mutant bacteria also induced markedly reduced meningeal inflammation and brain pathology compared with wild type, despite similar levels of bacteremia. Immunization of mice with GlpO protected against invasive pneumococcal disease and provided additive protection when formulated with pneumolysin toxoid. Our results provide the basis of a strategy that can be adapted to identify genes that contribute to the development of meningitis caused by other pathogens.

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“…In all age groups after 24 years, S. pneumoniae was the predominant aetiological agent. This is expected because the conjugate vaccines introduced against S. pneumoniae (PCV) is expected to reduce the burden of childhood pneumococcal meningitis substantially [32,33].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of bacterial meningitis surveillance data of the Northern Region, Ghana, 2010-2015

Kaburi¹,

Kubio²,

Kenu³

et al. 2018

Pan Afr Med J Conf Proc

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Introduction: Bacterial meningitis is a disease of major public health importance especially for countries such as Ghana; whose northern part lies within the meningitis belt. The Northern region of Ghana has been recording cases with outbreaks over the years. In order to generate evidence to improve surveillance, we described the epidemiology of bacterial meningitis using surveillance data of the northern region. Methods: Bacterial meningitis datasets from January 2010 to December 2015 for all the 26 districts of the Northern region were retrieved from line lists. Data were analyzed in terms of person, place, time, and identity of causative organisms using descriptive statistics. The results were presented as proportions, rates, tables and graphs. Results: A total of 1,176 cases were reported. Of these, 53.5% (629/1,176) were males. The proportion of cases aged 0 to 29 years was 77.4%. The Overall Case Fatality Rate (CFR) was 9.7% (114/1,176). About 65% of all cases were recorded from January to April. Only 23.7% (279/1,176) of cases were laboratory-confirmed. Neisseria meningitides and Streptococcus pneumonia accounted for 91.4% of confirmed cases. Over the period, the incidence reduced from 9.0/100,000 population to 3.8/100,000 population and CFR reduced from 16.6% to 5.7%. Conclusion: Most cases of bacterial meningitis were recorded in the dry season and in persons younger than 30 years. Less than a quarter of cases were laboratory confirmed, and no new bacteria species were identified. Both morbidity and mortality rates were on the decline.There is the need to consolidate these gains by intensifying meningitis surveillance and improving on the rate of laboratory case confirmation.

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Changing epidemiology of bacterial meningitis

Cited by 57 publications

References 46 publications

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

Identification of a novel pneumococcal vaccine antigen preferentially expressed during meningitis in mice

Evaluation of bacterial meningitis surveillance data of the Northern Region, Ghana, 2010-2015

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