Wilson-Clark Samantha D, Squires S, Deeks S
Immunization and Respiratory Infections Division, Public Health Agency of Canada, Ottawa, Canada.
MMWR Suppl. 2006 Apr 28;55(1):20-4.
In July 2002, a cluster of bacterial meningitis (BM) cases was identified among European cochlear implant recipients (CIRs), prompting Health Canada to conduct a retrospective cohort study to determine the rate of BM infection among Canadian CIRs and to identify risk factors for acquiring BM.
A survey was mailed to 1,432 Canadian CIRs who had received implants during January 1995-July 2002 to assess occurrence of postimplant BM infection. Data collection included demographics, episodes of meningitis, and vaccination status.
A total of 1,024 (72%) surveys were completed. Median age of CIRs at implantation was 16 years (range: 7 months-81 years). Five (0.5%) cases of BM infection were reported (two pneumococcal, one meningococcal, and two of unknown etiology); one CIR died. Four cases occurred among children aged <18 years. Time between implantation and BM infection varied (range: 7 months-7.7 years; median: 11 months). The rate of BM infection per 1,000 person-years was 0.7 among CIRs aged > or =18 years and 2.9 among those aged <18 years. The proportion of CIRs vaccinated against pneumococcal and meningococcal disease was low (46% and 41%, respectively). Preimplant meningitis was identified as a risk factor for postimplant BM (p = 0.002). No other risk factors evaluated were associated with an increased risk for BM infection.
CIRs have a high rate of postimplant BM infection. Preimplant BM infection was identified as a risk factor. Cases of BM infection might have been prevented through vaccination.
2002年7月，在欧洲人工耳蜗植入受者（CIR）中发现了一批细菌性脑膜炎（BM）病例，促使加拿大卫生部开展一项回顾性队列研究，以确定加拿大CIR中BM感染的发生率，并确定获得BM的危险因素。
向1995年1月至2002年7月期间接受植入的1432名加拿大CIR邮寄调查问卷，以评估植入后BM感染的发生情况。数据收集包括人口统计学信息、脑膜炎发作情况和疫苗接种状况。
共完成了1024份（72%）调查问卷。CIR植入时的中位年龄为16岁（范围：7个月至81岁）。报告了5例（0.5%）BM感染病例（2例肺炎球菌性、1例脑膜炎球菌性和2例病因不明）；1名CIR死亡。4例发生在18岁以下儿童中。植入与BM感染之间的时间各不相同（范围：7个月至7.7年；中位时间：11个月）。年龄≥18岁的CIR中每1000人年的BM感染率为0.7，18岁以下者为2.9。接种肺炎球菌和脑膜炎球菌疾病疫苗的CIR比例较低（分别为46%和41%）。植入前脑膜炎被确定为植入后BM的一个危险因素（p = 0.002）。评估的其他危险因素均与BM感染风险增加无关。
CIR植入后BM感染率较高。植入前BM感染被确定为一个危险因素。通过接种疫苗可能预防BM感染病例。
