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[The trend of childhood bacterial meningitis in Japan (1997.7-2000.6)]
K Sunakawa1, M Nonoyama, Y Takayama
1Dep. of Infectious Diseases, Kitasato Univ. School of Med.
Insights
Pediatric purulent meningitis cases were analyzed in Japan. Drug-resistant bacteria like Haemophilus influenzae and Streptococcus pneumoniae are increasing, necessitating treatment reconsideration.
Area of Science:
- Epidemiology
- Infectious Diseases
- Pediatrics
Context:
- Purulent meningitis poses a significant threat to pediatric populations.
- Understanding causative pathogens and their resistance patterns is crucial for effective treatment.
Purpose:
- To survey the epidemiology of pediatric purulent meningitis in Japan.
- To identify common pathogens and assess their antimicrobial resistance.
- To evaluate the implications for current treatment strategies.
Summary:
- A 3-year survey (1997-2000) identified 428 cases of pediatric purulent meningitis in Japan.
- Infections were most common in infants under one year, particularly neonates.
- Key pathogens included Haemophilus influenzae, Streptococcus pneumoniae, group B Streptococcus, and Escherichia coli.
- Significant drug resistance was observed in H. influenzae (25.3%) and S. pneumoniae (38.7%) isolates.
- Resistance rates were higher when analyzing resistant genes, suggesting underestimation in standard susceptibility tests.
Impact:
- Findings indicate a rising prevalence of drug-resistant bacteria, potentially reducing the efficacy of standard treatments like ampicillin and cefotaxime.
- The study highlights the urgent need to reconsider and adapt treatment protocols for pediatric purulent meningitis.
- This research contributes to public health strategies for managing pediatric infectious diseases and antimicrobial resistance.
Abstract:
We surveyed the epidemiology of purulent meningitis in pediatrics for 3 years between July 1997 and June 2000 in Japan and obtained the following results. The number of cases of purulent meningitis was 428, which was equivalent of 1.1-1.7 children out of 1,000 hospitalized those in pediatrics per year. The age-distribution for the infections was the highest under 1 year of age and it decreased as the age increased. Under 1 year of age, the highest distribution was observed in one month of age and under 1 month of age, the highest distribution was observed in 7 days of or younger ages. Haemophilus influenzae was the most common pathogen causing the infections, followed by Streptococcus pneumoniae, group B streptococcus, and Escherichia coli. Relationship between causing pathogens and age-distribution was as follows: group B streptococcus and E. coli were major pathogens under 4 months of age and H. influenzae and S. pneumoniae were major pathogens over 3 months of age. Susceptibility tests performed at each facility demonstrated that 25.3% of H. influenzae isolates and 38.7% of S. pneumoniae isolates were drug-resistant. Analysis of resistant genes for H. influenzae and S. pneumoniae isolates, which were stored and sent, demonstrated higher rates of resistance than those observed in susceptibility tests. These results suggest that the increase in insufficient efficacy of usual treatment with combination of ampicillin and cefotaxime is predictable against the infections. Therefore, the treatment for the infections should be reconsidered.