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Published on: October 29, 2014

Non-neonatal meningitis due to less common bacterial pathogens, the Netherlands, 1975-83

L Spanjaard, P Bol, H C Zanen

    The Journal of Hygiene
    |October 1, 1986
    PubMed

    Insights

    Bacterial meningitis in the Netherlands, excluding common causes, has an incidence of 0.8/100,000 yearly. Escherichia coli and Listeria monocytogenes are frequent culprits, with significant fatality and sequelae rates.

    Area of Science:

    • * Infectious Diseases
    • * Microbiology
    • * Epidemiology

    Background:

    • * Meningitis can be caused by various bacteria beyond the most common pathogens.
    • * Understanding the epidemiology and clinical course of less common bacterial meningitis is crucial for public health.
    • * Previous studies have focused on Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae, leaving gaps in knowledge for other bacterial causes.

    Purpose of the Study:

    • * To investigate the associations between bacteriological data and disease course in meningitis cases caused by less common bacteria in the Netherlands.
    • * To determine the incidence, case-fatality rates, and types of sequelae associated with these pathogens.
    • * To identify predisposing factors and highlight the importance of surveillance and antibiotic treatment strategies.

    Main Methods:

    • * Retrospective review of case histories of 160 patients over 1 month old with meningitis from non-Neisseria meningitidis, non-Haemophilus influenzae, and non-Streptococcus pneumoniae bacterial causes.
    • * Analysis of bacteriological data, clinical course, predisposing factors, and outcomes including fatality and sequelae.
    • * Calculation of incidence rates and comparison of outcomes between Gram-negative and Gram-positive bacterial meningitis.

    Main Results:

    • * The incidence of meningitis due to these other bacteria was approximately 0.8 per 100,000 person-years.
    • * Escherichia coli and Listeria monocytogenes each represented about 15% of the cases.
    • * The overall case-fatality rate was 18.8%, with higher rates for Gram-negative bacteria (25%) compared to Gram-positives (15%).
    • * Sequelae occurred in 13.3% of survivors, most commonly hearing loss (5.0%).
    • * Predisposing factors were identified in 70% of patients, particularly for meningitis caused by enteric Gram-negative bacteria and staphylococci.

    Conclusions:

    • * Bacterial meningitis in the Netherlands, excluding common causes, presents a significant public health concern with notable mortality and morbidity.
    • * The incidence of these less common meningitis cases may increase, necessitating ongoing surveillance.
    • * Challenges in antibiotic treatment for these pathogens underscore the need for further research and improved therapeutic strategies.

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