Faye-Ketté H, Doukou E S, Boni C, Akoua-Koffi C, Diallo-Touré K, Kacou-N'Douba A, Bouzid S, Dossso M, Timité-Konan M
Laboratoire de bactériologie-virologie, CHU de Yopougon, Faculté de médecine et Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire.
Bull Soc Pathol Exot. 2003 Nov;96(4):313-6.
To assess prevalence and trends of community acquired bacterial meningitis in childhood in a tertiary-care hospital before introduction of the HIB conjugate vaccine.
Laboratory based data were recorded from January 1995 to December 2000 on two hundred and eighty seven children with bacterial meningitis. Identification of bacterial agents was performed with conventional methods. Information including age, gender, bacterial aetiology of meningitis, month and annual prevalence of agents was examined.
The age of infected children ranges from 1 to 10 years with an average and median age of 34.2 months and 12 months respectively. Fifty five percent of children were male. The overall prevalence of agents were respectively 47.8% for Streptococcus pneumoniae followed by Haemophilus influenzae 39% and Neisseria meningitidis 13.2% with predominance of serogroup C. Stratification by age group shows that Haemophilus influenzae was the most common agent among children < 1 year of age following by S. pneumoniae and N. meningitidis. After 5 years, the number of cases of S. pneumoniae and N. meningitidis was prevalent. After 10 years, N. meningitidis was the first aetiology of bacterial meningitis. The six years data recorded highlighted the high and stable prevalence of H. influenzae B and S. pneumoniae and the low prevalence of N. meningitidis and high incidence of invasive meningococcal, pneumococcal and Haemophilus influenzae during the six years between September and February.
Conjugated HIB vaccine is needed in our country to lower incidence of H. influenzae meningitis as already seen in developed countries. Continuous surveillance is necessary to monitor the disease trends, serotype distribution and antimicrobial susceptibility in order to implement appropriate public health interventions against community acquired bacterial meningitis.
评估在引入b型流感嗜血杆菌结合疫苗之前，一家三级护理医院儿童社区获得性细菌性脑膜炎的患病率及趋势。
记录了1995年1月至2000年12月期间287例细菌性脑膜炎患儿的基于实验室的数据。采用传统方法对细菌病原体进行鉴定。检查了包括年龄、性别、脑膜炎的细菌病因、病原体的月份和年度患病率等信息。
受感染儿童的年龄在1至10岁之间，平均年龄和中位数年龄分别为34.2个月和12个月。55%的儿童为男性。病原体的总体患病率分别为：肺炎链球菌47.8%，其次是流感嗜血杆菌39%，脑膜炎奈瑟菌13.2%，以C群为主。按年龄组分层显示，流感嗜血杆菌是1岁以下儿童中最常见的病原体，其次是肺炎链球菌和脑膜炎奈瑟菌。5年后，肺炎链球菌和脑膜炎奈瑟菌的病例数普遍增多。10年后，脑膜炎奈瑟菌是细菌性脑膜炎的首要病因。记录的六年数据突出显示了b型流感嗜血杆菌和肺炎链球菌的高患病率且稳定，脑膜炎奈瑟菌的患病率低，以及在9月至2月的六年期间侵袭性脑膜炎球菌、肺炎球菌和流感嗜血杆菌的高发病率。
我国需要使用b型流感嗜血杆菌结合疫苗来降低流感嗜血杆菌脑膜炎的发病率，正如在发达国家已经见到的那样。持续监测对于监测疾病趋势、血清型分布和抗菌药物敏感性是必要的，以便针对社区获得性细菌性脑膜炎实施适当的公共卫生干预措施。
