Ceyhan Mehmet, Yildirim Inci, Balmer Paul, Borrow Ray, Dikici Bunyamin, Turgut Mehmet, Kurt Nese, Aydogan Aysel, Ecevit Cigdem, Anlar Yasar, Gulumser Ozlem, Tanir Gonul, Salman Nuran, Gurler Nezahat, Hatipoglu Nevin, Hacimustafaoglu Mustafa, Celebi Solmaz, Coskun Yavuz, Alhan Emre, Celik Umit, Camcioglu Yildiz, Secmeer Gulten, Gur Deniz, Gray Steve
Hacettepe University, Ankara, Turkey.
Emerg Infect Dis. 2008 Jul;14(7):1089-96. doi: 10.3201/eid1407.070938.
Determination of the etiology of bacterial meningitis and estimating cost of disease are important in guiding vaccination policies. To determine the incidence and etiology of meningitis in Turkey, cerebrospinal fluid (CSF) samples were obtained prospectively from children (1 month-17 years of age) with a clinical diagnosis of acute bacterial meningitis. Multiplex PCR was used to detect DNA evidence of Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis. In total, 408 CSF samples were collected, and bacterial etiology was determined in 243 cases; N. meningitidis was detected in 56.5%, S. pneumoniae in 22.5%, and Hib in 20.5% of the PCR-positive samples. Among N. meningitidis-positive CSF samples, 42.7%, 31.1%, 2.2%, and 0.7% belonged to serogroups W-135, B, Y, and A, respectively. This study highlights the emergence of serogroup W-135 disease in Turkey and concludes that vaccines to prevent meningococcal disease in this region must provide reliable protection against this serogroup.
确定细菌性脑膜炎的病因并估算疾病成本对于指导疫苗接种政策至关重要。为了确定土耳其脑膜炎的发病率和病因，前瞻性地收集了临床诊断为急性细菌性脑膜炎的儿童（1个月至17岁）的脑脊液（CSF）样本。采用多重聚合酶链反应（PCR）检测肺炎链球菌、b型流感嗜血杆菌（Hib）和脑膜炎奈瑟菌的DNA证据。总共收集了408份脑脊液样本，243例病例确定了细菌病因；在PCR阳性样本中，脑膜炎奈瑟菌检出率为56.5%，肺炎链球菌为22.5%，Hib为20.5%。在脑膜炎奈瑟菌阳性的脑脊液样本中，分别有42.7%、31.1%、2.2%和0.7%属于W-135、B、Y和A血清群。本研究突出了土耳其W-135血清群疾病的出现，并得出结论，该地区预防脑膜炎球菌疾病的疫苗必须对该血清群提供可靠的保护。
