Epidemiological analysis on two decades of hospitalisations for meningitis in the United States

Abstract

Bacterial meningitis is an important source of mortality and morbidity worldwide. Data exist on specific vaccines against Streptococcus pneumoniae and Neisseria meningitidis indicating that they reduce the incidence of meningitis, yet comprehensive information on the trend of bacterial meningitis is still lacking. We analysed the Kids' Inpatient Database and the National Inpatient Database considering all bacterial meningitides in the United States, excluding cases of tuberculosis and sexually transmitted diseases. We analysed the trend of meningitis incidence from 1993 to 2011 and in specific age groups before and after the introduction of the pneumococcal conjugate vaccine 7 (PCV-7) and the meningococcal conjugate vaccine 4 (MCV-4). Moreover, we analysed the prevalence of aetiological agents to assess their changes. We estimated 295,706 cases of meningitis having occurred in the United States and a reduction of the discharge rate of 21 %. We observed a significant reduction in cases of meningitis in children and elderly patients following the introduction of the PCV-7. We also found a reduction in subjects aged 10-14 years, an age span consistent with the introduction of MCV-4, although further analyses based on serotypes data are required to confirm this observation. By contrast, we observed an increased prevalence of cases of staphylococcal and streptococcal meningitides. The introduction of PCV-7 has reduced the incidence and changed significantly the aetiology of bacterial meningitis in the United States during the last two decades.

Meningitis caused by Neisseria Meningitidis, Hemophilus Influenzae Type B and Streptococcus Pneumoniae during 2005–2012 in Turkey

“…1,14,37 Hib and PCV-13 vaccines are already available for infants starting from two months of age in the Turkish NIP and the meningococcal vaccine for Hajj pilgrims has already been switched to conjugated quadrivalent vaccine in order to decrease carriage of the microorganism by returning pilgrims. In this study we observed a drastic decreased of Hib meningitis in Turkish children since Hib vaccine has been introduced in NIP.…”

On vaccine's adjuvants and autoimmunity: Current evidence and future perspectives

“…The results generated by these interventions on human health and longevity changed profoundly the historical relationship between infectious diseases and human race [2][3][4]. The eradication of smallpox and the large reduction of cases of poliomyelitis and measles are some examples of the beneficial impact of immunisation programmes [2,3].…”

Treatment strategies for central nervous system infections: an update

“…Meningitis caused by Staphylococcus aureus differs from other bacterial meningitis in its pathogenesis, usually occurring following postneurosurgical procedure or head trauma. From 1997 to 2011, the incidence of pneumococcal and meningococcal meningitis declined by 8 and 6%, respectively [6]. In a report from 1998 to 2007 in the USA, S. pneumoniae accounted for 58% of the cases, followed by group B Streptococcus (GBS) (18.1%), N. meningitidis (13.9%) and H. influenzae (6.7%) [7].…”

“…Initial treatment of suspected bacterial meningitis 6.1 Empiric treatment of suspected bacterial meningitis Bacterial meningitis needs prompt antibiotics administration. Empirical antibiotics should not be delayed either by lumbar puncture or by CT ( Table 6).…”

“…The big epidemic in recent years was in 2009 with 79,296 cases and 4288 deaths [5]. In a retrospective analysis, 295,706 cases of bacterial meningitis were identified between 1993 and 2011 in the USA with a significant reduction of meningitis in children and the elderly [6]. The highest incidence of meningitis was in the age group < 1 years with an increase of incidence in the age group 45 --64 years.…”