Wang Jiun-Ling, Liu Ding-Ping, Yen Jer-Jea, Yu Chia-Jung, Liu Hsi-Chen, Lin Ching-Yuang, Chang Shan-Chwen
Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan.
BMC Infect Dis. 2006 Jan 19;6:7. doi: 10.1186/1471-2334-6-7.
Few published reports have evaluated the clinical features and outcome of serogroup W135 meningococcal disease. In Taiwan, W135 is the second most prevalent meningococcal disease serogroup.
A nationwide study was conducted to retrospectively analyze epidemiologic data from 115 patients with laboratory confirmed meningococcal disease that occurred from 2001 through 2003.
Serogroup W135 accounted for 26% of all cases and most (76.7%) were older than 20 years. There were no cases of serogroup W135 meningococcal disease associated with Hajj pilgrims, and all cases were sporadic. In 88 patients with complete case records, we compared the presenting symptoms, signs, laboratory data, and outcomes between W135 and non-W135 patients. There were no differences in presenting symptoms except for the higher prevalence of pneumonia found in W135 patients (23.8% vs. 1.5%; OR: 20.6; 95%CI: 2.3-189.0; p = 0.003). The distribution of inflammatory cells in CSF in patients with meningitis was also different between W135 and non-W135 patients. W135 patients had a trend toward more intubations and shock but it did not achieve statistical significance. In multivariate analysis of factors associated with death, three independent factors were found: bacteremia without meningitis, altered mental status, and petechiae or purpura on admission.
Sporadic serogroup W135 meningococcal disease is an important component of the meningococcal disease burden in Taiwan, but it is not directly associated with Hajj pilgrims. Compared with patients infected by other serogroups of meningococci, patients with serogroup W135 were older and more likely to have extrameningeal involvement such as pneumonia.
很少有已发表的报告评估W135群脑膜炎球菌病的临床特征和转归。在台湾，W135是第二常见的脑膜炎球菌病血清群。
开展了一项全国性研究，回顾性分析2001年至2003年期间115例实验室确诊的脑膜炎球菌病患者的流行病学数据。
W135群占所有病例的26%，大多数（76.7%）患者年龄超过20岁。没有W135群脑膜炎球菌病病例与朝觐朝圣者相关，所有病例均为散发性。在88例有完整病例记录的患者中，我们比较了W135群和非W135群患者的症状、体征、实验室数据及转归。除W135群患者中肺炎患病率较高外（23.8%对1.5%；比值比：20.6；95%可信区间：2.3 - 189.0；p = 0.003），症状表现无差异。脑膜炎患者脑脊液中炎症细胞的分布在W135群和非W135群患者之间也有所不同。W135群患者有插管和休克增多的趋势，但未达到统计学显著性。在与死亡相关因素的多变量分析中，发现了三个独立因素：无脑膜炎的菌血症、精神状态改变及入院时的瘀点或紫癜。
散发性W135群脑膜炎球菌病是台湾脑膜炎球菌病负担的重要组成部分，但与朝觐朝圣者无直接关联。与感染其他血清群脑膜炎球菌的患者相比，W135群患者年龄较大，更易出现如肺炎等脑膜外受累情况。
