González-Escartín Esther, Angulo López Itziar, Ots Ruiz Elsa, Martínez-Martínez Luis, Cabero Pérez María J
Servicio de Pediatría, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
Arch Argent Pediatr. 2017 Apr 1;115(2):160-164. doi: 10.5546/aap.2017.eng.160.
To analyze the characteristics of pneumococcal meningitis in children ≤ 14 years old following the market introduction of pneumococcal conjugate vaccines in our community.
Retrospective study of pneumococcal meningitis cases with a two-period analysis: pre-13-valent pneumococcal conjugate vaccine (PCV13) (2001-2010) and post-PCV13 (2010-2015). Patient demographic and clinical data, and microbiological data were collected.
Eighteen cases were diagnosed. The mean incidence in the pre-PCV13 period was 2.3/100 000, which reduced to 0.5/100 000 after the PCV13 introduction. The most commonly identified serotypes were 6A and 10A (pre-PCV13); 6B and 15B (post-PCV13, only 2 cases). Out of 18 patients, 13 were admitted to the intensive care unit. All cases were treated with cefotaxime, and 14/18 received dexamethasone. Six patients survived with sequelae, and 1 died.
A major reduction has been observed in the incidence of pneumococcal meningitis since the introduction of the PCV13 to the market, so an even greater reduction is expected following its systematic introduction.
分析在我们社区引入肺炎球菌结合疫苗后14岁及以下儿童肺炎球菌脑膜炎的特征。
对肺炎球菌脑膜炎病例进行回顾性研究，并进行两阶段分析：13价肺炎球菌结合疫苗（PCV13）引入前（2001 - 2010年）和PCV13引入后（2010 - 2015年）。收集患者的人口统计学和临床数据以及微生物学数据。
共诊断出18例病例。PCV13引入前的平均发病率为2.3/10万，引入PCV13后降至0.5/10万。最常见的血清型在PCV13引入前为6A和10A；PCV13引入后为6B和15B（仅2例）。18例患者中有13例入住重症监护病房。所有病例均接受头孢噻肟治疗，18例中有14例接受了地塞米松治疗。6例患者存活但有后遗症，1例死亡。
自PCV13上市以来，肺炎球菌脑膜炎的发病率已大幅下降，因此预计在其系统引入后发病率会进一步大幅下降。
