Vårdcentralen Lunden, Ystadgatan 53c, 214 44, Malmö, Sweden.
Department of Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, 221 85, Lund, Sweden.
Infection. 2024 Aug;52(4):1377-1384. doi: 10.1007/s15010-024-02195-z. Epub 2024 Feb 28.
Bacterial meningitis is a rare, but life-threatening disease, which sometimes occurs as a complication to acute otitis media (AOM). The proportion of meningitis cases originating from AOM is not clear.
The aim of this study was to investigate the proportion of meningitis cases caused by AOM, to compare risk factors, bacteriology and outcome between otogenic and non-otogenic meningitis, and to analyse the incidence of bacterial meningitis after the introduction of conjugate pneumococcal vaccines (PCV).
The medical charts of all patients admitted to hospitals in southern Sweden with bacterial meningitis between 2000 and 2017 were retrieved. Based on otoscopy and/or imaging, the proportion of otogenic meningitis cases was calculated, as were annual incidences.
A total of 216 patients were identified, 25 of whom died. The proportion of otogenic meningitis was 31% but varied from 6% among teenagers to 40% among adults. Before PCV, 23% of all meningitis cases were children < 2 years, compared to 1% post-PCV. The average incidence in the adult population, on the other hand, increased post-PCV, though there were large annual variations. S. pneumoniae was the most commonly identified pathogen in everyone but teenagers, in whom N. meningitidis was predominant.
AOM is an important cause of meningitis in children and adults. Though bacterial meningitis almost disappeared in children < 2 years after the introduction of PCV, the incidence of pneumococcal meningitis in adults seems to have increased.
细菌性脑膜炎是一种罕见但危及生命的疾病，有时作为急性中耳炎（AOM）的并发症发生。由 AOM 引起的脑膜炎病例比例尚不清楚。
本研究旨在调查由 AOM 引起的脑膜炎病例比例，比较耳源性和非耳源性脑膜炎的危险因素、细菌学和结果，并分析结合肺炎球菌疫苗（PCV）引入后细菌性脑膜炎的发病率。
检索了 2000 年至 2017 年在瑞典南部医院因细菌性脑膜炎住院的所有患者的病历。根据耳镜检查和/或影像学检查，计算了耳源性脑膜炎病例的比例和年发病率。
共确定了 216 名患者，其中 25 名死亡。耳源性脑膜炎的比例为 31%，但在青少年中为 6%，在成年人中为 40%。在 PCV 之前，所有脑膜炎病例中有 23%是<2 岁的儿童，而 PCV 之后则为 1%。另一方面，成年人的平均发病率在 PCV 之后增加了，尽管每年都有很大的变化。除了青少年之外，所有人（包括青少年）中最常见的病原体都是肺炎链球菌，而脑膜炎奈瑟菌则是青少年的主要病原体。
AOM 是儿童和成人脑膜炎的重要病因。虽然在 PCV 引入后，<2 岁的儿童细菌性脑膜炎几乎消失，但成年人中肺炎球菌性脑膜炎的发病率似乎有所增加。
