Lieberman J M, Greenberg D P, Ward J I
Pediatric Infectious Diseases, Harbor-UCLA Medical Center, Torrance.
Infect Dis Clin North Am. 1990 Dec;4(4):703-29.
The morbidity and mortality caused by bacterial meningitis remains significant despite advances in antimicrobial therapy and supportive care. Prevention of meningitis by routine immunization of infants, who are at greatest risk, offers the only practical way of reducing the incidence of this disease. Widespread use of the recently developed protein conjugate vaccines against Haemophilus influenzae type b by itself could reduce the incidence of bacterial meningitis in the U.S. by more than half. To prevent disease caused by the other pathogens, an effective vaccine against the group B meningococcus must be developed, and the immunogenicity of the pneumococcal and quadrivalent meningococcal vaccines should be improved. Until such time that universal immunization of infants with highly immunogenic vaccines is possible, continued efforts must focus on targeting immunization at high-risk individuals and using chemoprophylaxis to prevent secondary disease where indicated. Addendum: On October 4, 1990, the U.S. Food and Drug Administration licensed the praxis Haemophilus influenzae type b-protein conjugate vaccine (Hboc) for use in infants at 2, 4, and 6 months of age with a booster dose at 15-18 months. Physicians are directed to statements by the Immunizations Practices Advisory Committee and the American Academy of Pediatrics for official recommendations concerning its use.
尽管在抗菌治疗和支持治疗方面取得了进展，但细菌性脑膜炎引起的发病率和死亡率仍然很高。通过对风险最高的婴儿进行常规免疫来预防脑膜炎，是降低这种疾病发病率的唯一可行方法。在美国，广泛使用最近研发的针对b型流感嗜血杆菌的蛋白结合疫苗本身就可以将细菌性脑膜炎的发病率降低一半以上。为预防由其他病原体引起的疾病，必须研发一种针对B群脑膜炎球菌的有效疫苗，并且应提高肺炎球菌疫苗和四价脑膜炎球菌疫苗的免疫原性。在能够对婴儿进行高免疫原性疫苗的普遍免疫之前，必须继续努力将免疫接种目标对准高危个体，并在适当情况下使用化学预防措施来预防继发性疾病。附录：1990年10月4日，美国食品药品监督管理局批准百克沙（Hboc）b型流感嗜血杆菌蛋白结合疫苗用于2、4和6月龄婴儿，并在15至18月龄时加强接种一剂。医生应参考免疫实践咨询委员会和美国儿科学会的声明，以获取有关该疫苗使用的官方建议。
