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[A study of bacterial meningitis in Hokkaido between 1994 and 1998]
1Department of Pediatrics, Asahikawa Kosei Hospital.
Abstract:
We evaluated 82 children with bacterial meningitis in 78 institutions in Hokkaido, Japan between 1994 and 1998. The mean number of cases per year was 16.4 (range, 9 to 30). A male predominance occurred with 52 males and 30 females (1.7:1). Median age was 11 months with a range from 1 day to 11 years. Seventy-eight (95%) of the total were less than 5 years old with 55 (67%) less than 2 years old and 45 (55%) less than 1-year old. Four deaths occurred, giving an overall case fatality rate of 4.9%. Sequelae were seen at discharge in 29%, predominantly sensorineural hearing loss, epilepsy and development delay of varying severity. The main causative organisms were Haemophilus influenzae in 49 patients, Streptococcus pneumoniae in 14, Streptococcus agalactiae in 10 and Escherichia coli in 5. The frequency of poor prognosis was 50% for patients with meningitis due to S. pneumoniae or S. agalactiae compared with 27% for patients with meningitis due to H. influenzae.
Insights
This study on childhood bacterial meningitis in Hokkaido found Haemophilus influenzae to be the most common cause. Streptococcus pneumoniae and Streptococcus agalactiae infections were associated with a higher risk of poor prognosis in children.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Bacteriology
Context:
- Bacterial meningitis remains a significant cause of childhood morbidity and mortality globally.
- This study examines a cohort of pediatric bacterial meningitis cases in Hokkaido, Japan, over a defined period (1994-1998).
- Understanding regional and temporal trends in causative agents and outcomes is crucial for public health interventions.
Purpose:
- To describe the epidemiology, clinical characteristics, causative organisms, and outcomes of bacterial meningitis in children treated in Hokkaido, Japan.
- To identify risk factors associated with poor prognosis and sequelae.
- To inform clinical management and public health strategies for pediatric bacterial meningitis.
Summary:
- A total of 82 children with bacterial meningitis were analyzed from 78 institutions between 1994 and 1998.
- The majority of cases (95%) occurred in children under 5 years old, with a male predominance.
- Key pathogens identified were Haemophilus influenzae (49%), Streptococcus pneumoniae (14%), Streptococcus agalactiae (10%), and Escherichia coli (5%).
- The overall case fatality rate was 4.9%, with 29% experiencing sequelae, including sensorineural hearing loss and developmental delay.
- Meningitis caused by S. pneumoniae or S. agalactiae showed a higher frequency of poor prognosis (50%) compared to H. influenzae (27%).
Impact:
- This research highlights the significant burden of bacterial meningitis in young children in Hokkaido.
- The findings underscore the importance of early diagnosis and appropriate treatment, particularly for infections caused by S. pneumoniae and S. agalactiae.
- Data on causative agents and outcomes can guide vaccination strategies and resource allocation for pediatric infectious diseases.