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Epidemiology and diagnosis of meningitis: results of a five-year prospective, population-based study

K Jolly1, G Stewart

  • 1Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham, B15 2TT. C.B.Jolly@bham.ac.uk

Communicable Disease and Public Health
|August 30, 2001
PubMed

Insights

Reinforce advice for general practitioners to administer pre-admission benzylpenicillin for suspected meningitis or meningococcal septicaemia. Early penicillin use is crucial for better outcomes in bacterial meningitis cases.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Meningitis diagnosis has evolved with new guidelines and diagnostic tools.
  • Changes include pre-admission penicillin advice, reduced lumbar puncture rates, and routine use of meningococcal polymerase chain reaction (PCR) testing.
  • These shifts necessitate a re-evaluation of diagnostic practices for meningitis.

Purpose of the Study:

  • To reassess meningitis diagnostic strategies in light of recent clinical and laboratory advancements.
  • To evaluate the impact of pre-admission benzylpenicillin and meningococcal PCR on diagnosis and outcomes.
  • To identify key predictors of meningitis mortality.

Main Methods:

  • Retrospective analysis of meningitis cases (1994-1998) in a health district.
  • Data collection on pre-admission benzylpenicillin use, lumbar puncture rates, and microbiological confirmation.
  • Statistical analysis to determine the impact of interventions and identify mortality predictors.

Main Results:

  • Of 355 meningitis cases, 258 (73%) involved meningococcal disease.
  • Only 28% of meningococcal cases received pre-admission benzylpenicillin.
  • Lumbar puncture rates decreased from 79% (1994) to 61% (1998).
  • Meningococcal PCR introduction in 1996 increased confirmation rates from 48% to 68%.
  • Age was an independent predictor of meningitis mortality.

Conclusions:

  • Pre-admission benzylpenicillin advice for suspected meningitis/septicaemia should be reinforced for all patients.
  • Meningococcal PCR significantly improves microbiological confirmation rates.
  • Age and serogroup are critical factors in meningococcal meningitis mortality.

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