Kyaw Moe H, Christie Peter, Jones Ian G, Campbell Harry
Public Health Sciences, University of Edinburgh, UK.
Scand J Infect Dis. 2002;34(4):289-98. doi: 10.1080/00365540110080403.
We reviewed population-based laboratory reports of invasive meningococcal, pneumococcal, Haemophilus influenzae, Group B Streptococcus (GBS) and Listeria monocytogenes isolates in order to examine the changing epidemiology of meningitis and invasive non-meningitic disease (INMD) caused by these 5 pathogens in the 2 periods before (1983-91) and after (1992-99) routine use of H. influenzae type B conjugate vaccine (Hib) in Scotland. Neissieria meningitidis was the most common cause of meningitis, accounting for 39.2% of cases of meningitis in 1983-91 and 47% of cases in 1992-99, followed by H. influenzae (31%), Streptococcus pneumoniae (22.4%), GBS (3.9%) and L. monocytogenes (3.5%) in 1983-91 and S. pneumoniae (36.3%), H. influenzae (7.8%), GBS (6.1%) and L. monocytogenes (2.8%) in 1992-99. The important epidemiological features of meningitis and INMD caused by these 5 pathogens between 1983-91 and 1992-99 include: 1. The incidence of bacterial meningitis due to S. pneumoniae and GBS was stable; 2. S. pneumoniae was the predominant cause of INMD in both periods; 3. The incidences of INMD caused by N. meningitidis, GBS and S. pneumoniae increased, by 27%, 55% and 56%, respectively; 4. Decreases in the incidences of bacterial meningitis (by 50%) and INMD (by 50%) due to L. monocytogenes were detected; and 5. There were dramatic reductions in the proportions of bacterial meningitis (by 92%) and INMD (by 56%) due to H. influenzae in vaccinated and non-vaccinated individuals. Continued surveillance is necessary to monitor the disease trend, population at risk, serotype distribution and antimicrobial susceptibility in order to implement appropriate public health interventions against invasive bacterial disease.
我们回顾了基于人群的侵袭性脑膜炎球菌、肺炎球菌、流感嗜血杆菌、B族链球菌（GBS）和单核细胞增生李斯特菌分离株的实验室报告，以研究在苏格兰常规使用B型流感嗜血杆菌结合疫苗（Hib）之前（1983 - 91年）和之后（1992 - 99年）这5种病原体引起的脑膜炎和侵袭性非脑膜炎疾病（INMD）的流行病学变化。脑膜炎奈瑟菌是脑膜炎最常见的病因，在1983 - 91年占脑膜炎病例的39.2%，在1992 - 99年占47%，其次是流感嗜血杆菌（1983 - 91年为31%）、肺炎链球菌（22.4%）、GBS（3.9%）和单核细胞增生李斯特菌（3.5%），1992 - 99年则为肺炎链球菌（36.3%）、流感嗜血杆菌（7.8%）、GBS（6.1%）和单核细胞增生李斯特菌（2.8%）。1983 - 91年至1992 - 99年期间，这5种病原体引起的脑膜炎和INMD的重要流行病学特征包括：1. 肺炎链球菌和GBS引起的细菌性脑膜炎发病率稳定；2. 肺炎链球菌在两个时期都是INMD的主要病因；3. 脑膜炎奈瑟菌、GBS和肺炎链球菌引起的INMD发病率分别增加了27%、55%和56%；4. 检测到单核细胞增生李斯特菌引起的细菌性脑膜炎（下降50%）和INMD（下降50%）发病率降低；5. 接种疫苗和未接种疫苗个体中，流感嗜血杆菌引起的细菌性脑膜炎（下降92%）和INMD（下降56%）比例大幅降低。持续监测对于监测疾病趋势、高危人群、血清型分布和抗菌药物敏感性至关重要，以便针对侵袭性细菌疾病实施适当的公共卫生干预措施。
