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Pneumococcal meningitis in children: epidemiology, serotypes, and outcomes from 1997-2010 in Utah

Chris Stockmann1, Krow Ampofo, Carrie L Byington

  • 1Division of Pediatric Infectious Diseases, University of Utah Health Sciences Center, Salt Lake City, UT 84108, USA. chris.stockmann@hsc.utah.edu

Pediatrics
|August 28, 2013
PubMed

Insights

Pediatric pneumococcal meningitis remains a significant threat, with similar death and disability rates from both vaccine and non-vaccine serotypes. Continued immunization and surveillance are crucial.

Area of Science:

  • Pediatric infectious diseases
  • Vaccinology
  • Epidemiology

Background:

  • The 7-valent pneumococcal conjugate vaccine (PCV7) significantly reduced pediatric pneumococcal meningitis incidence in the US.
  • However, cases persist, raising questions about the comparative impact of PCV7 versus non-PCV7 serotypes on disease severity.

Purpose of the Study:

  • To compare the morbidity and mortality associated with pneumococcal meningitis caused by PCV7 and non-PCV7 serotypes in children.
  • To assess the long-term neurologic sequelae in survivors.

Main Methods:

  • A retrospective cohort study of laboratory-confirmed pneumococcal meningitis cases in Utah children (1997-2010).
  • Review of medical records for clinical data and follow-up on neurologic sequelae.

Main Results:

  • PCV7 serotypes decreased from 64% to 25% post-vaccine licensure (P < .01).
  • Overall case fatality rate was 13%, with no significant difference between PCV7 and non-PCV7 serotypes (P = .7).
  • Children with PCV7 serotype meningitis were more likely to require mechanical ventilation (68% vs 34%; P < .01), and 63% of survivors had neurologic sequelae, similar for both serotype groups (P = .1).

Conclusions:

  • Pneumococcal meningitis continues to cause high mortality and morbidity, regardless of serotype.
  • Neurologic sequelae are common in survivors of both PCV7 and non-PCV7 serotype meningitis.
  • The ongoing disease burden highlights the need for enhanced immunization strategies and surveillance, especially with the advent of PCV13.
Abstract

Keywords:
Streptococcus pneumoniaebacterial meningitischildrenneurologic sequelae

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