荷兰1988-2005年复发性细菌和真菌性脑膜炎的流行病学和微生物学特征

David

Clinical Infectious Diseases 2008;47:e42–e51
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4705-00E1$15.00
DOI: 10.1086/590251
MAJOR ARTICLE
Epidemiologic and Microbiologic Characteristics of Recurrent Bacterial and Fungal Meningitis in The Netherlands, 1988–2005
荷兰1988-2005年复发性细菌和真菌性脑膜炎的流行病学和微生物学特征
Joris J. van Driel,1,2
Vincent Bekker,1
Lodewijk Spanjaard,2,3
Arie van der Ende,2,3 and
Taco W. Kuijpers1

1Emma Children's Hospital, 2Department of Medical Microbiology, and 3Reference Laboratory for Bacterial Meningitis, Academic Medical Center, Center for Infection and Immunity, Amsterdam, The Netherlands

Background.  Patients may experience multiple episodes of bacterial meningitis. Information from large studies of recurrent meningitis is limited. We evaluated the incidence of recurrent bacterial meningitis and the distribution of causative organisms in The Netherlands.

Methods.  Data for patients with bacterial meningitis were prospectively collected nationwide for the period 1988–2005. Recurrent meningitis was defined as an episode of meningitis that either occurred 28 days after a previous episode or occurred <28 days after a previous episode but was caused by a different pathogen or different subtype of the same pathogen.

Results.  Of 18,915 patients, 202 (predominantly male) patients had recurrent bacterial meningitis ( ). Prevailing causative organisms were Streptococcus pneumoniae (40% of cases), Neisseria meningitidis (22%), and non–type b Haemophilus influenzae (9%). Pneumococci serotypes included in the heptavalent vaccine caused only 36% of cases of recurrent pneumococcal meningitis. The proportion of episodes caused by meningococcus serogroups W135, Y, and Z was higher among patients with recurrent meningitis than among those with nonrecurrent meningitis (odds ratio, 12.8), and the proportion caused by nontypeable and type f H. influenzae was also higher among patients with recurrent meningitis (odds ratio, 3.8 and 5.6, respectively).

Conclusions.  In The Netherlands, the prevalence of recurrent bacterial and fungal meningitis is low. The distribution of causative microorganisms differs between cases of recurrent meningitis and cases of nonrecurrent meningitis; this could be associated with vaccination.