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How common is otogenic meningitis? A retrospective study in southern Sweden over 18 years

Nora Bjar1, Ann Hermansson2, Marie Gisselsson-Solen3

  • 1Vårdcentralen Lunden, Ystadgatan 53c, 214 44, Malmö, Sweden.

Infection
|February 28, 2024
PubMed
Abstract

Insights

Acute otitis media (AOM) is a significant cause of bacterial meningitis, particularly in adults. While conjugate pneumococcal vaccines (PCV) reduced childhood cases, adult meningitis incidence appears to have risen.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Vaccinology

Background:

  • Bacterial meningitis is a severe complication of acute otitis media (AOM), but its exact contribution is unclear.
  • Understanding the link between AOM and meningitis is crucial for public health strategies.

Purpose of the Study:

  • To determine the proportion of meningitis cases originating from AOM.
  • To compare risk factors, pathogens, and outcomes in otogenic versus non-otogenic meningitis.
  • To analyze trends in bacterial meningitis incidence following the introduction of conjugate pneumococcal vaccines (PCV).

Main Methods:

  • Retrospective review of medical charts for bacterial meningitis patients in southern Sweden (2000-2017).
  • Calculation of otogenic meningitis proportion and annual incidences using otoscopy and/or imaging data.

Main Results:

  • 31% of bacterial meningitis cases were linked to AOM, with variations by age (6% in teenagers, 40% in adults).
  • PCV introduction drastically reduced meningitis in children under 2 (23% to 1%).
  • Adult meningitis incidence showed an increase post-PCV, with *S. pneumoniae* predominant except in teenagers (*N. meningitidis*).

Conclusions:

  • Acute otitis media is a notable cause of bacterial meningitis across age groups.
  • PCV has been highly effective in preventing meningitis in young children.
  • An increased incidence of pneumococcal meningitis in adults warrants further investigation.
Keywords:
AOMAcute otitis mediaBacterial meningitisComplicationPCVPneumococcal conjugate vaccine

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