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[Childhood bacterial meningitis trends in Japan from 2009 to 2010]

Masayoshi Shinjoh1, Satoshi Iwata, Yoshitake Sato

  • 1Center for Infectious Diseases and Infection Control, Keio University School of Medicine.

Kansenshogaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
|December 4, 2012
PubMed

Insights

Pediatric bacterial meningitis in Japan is most common in infants, with Haemophilus influenzae and Streptococcus pneumoniae as leading causes. High rates of antibiotic resistance were observed, and vaccination rates remain low.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Microbiology

Context:

  • Bacterial meningitis remains a significant concern in pediatric populations worldwide.
  • Epidemiological data on pediatric bacterial meningitis in Japan from 2009-2010 provides insight into causative agents and treatment patterns.
  • Low vaccination rates for Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines (PCV7) in Japan may influence disease burden.

Purpose:

  • To describe the epidemiology of pediatric bacterial meningitis in Japan.
  • To identify the most common bacterial pathogens causing meningitis in children.
  • To assess antibiotic resistance patterns and treatment strategies for pediatric bacterial meningitis.

Summary:

  • A survey of 314 pediatric bacterial meningitis cases in Japan (2009-2010) revealed that infants under one year old constituted the majority of cases.
  • Haemophilus influenzae was the predominant pathogen (53.2%), followed by Streptococcus pneumoniae (24.2%). Significant drug resistance was noted in isolates of both bacteria.
  • Treatment involved ampicillin/cephem or carbapenem/beta-lactam combinations, with cefotaxime/ceftriaxone or carbapenem as final choices. The overall fatality rate was 2.0%.

Impact:

  • The findings highlight the continued prevalence of bacterial meningitis in young children in Japan, particularly H. influenzae, despite potential for prevention through vaccination.
  • High rates of antibiotic resistance underscore the need for ongoing surveillance and judicious antibiotic use in pediatric meningitis management.
  • The low uptake of Hib and PCV7 vaccines suggests a missed opportunity for primary prevention, warranting strategies to improve immunization coverage.

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