Ara J R, Cía P, Arribas J L, Aguirre J M, de Juan F, Marco Tello A
Servicios de Neurología, Hospital Miguel Servet, Zaragoza.
Med Clin (Barc). 1994 Nov 12;103(16):611-4.
The aim of the present study was to know the incidence, etiology, prognostic factors and rate of mortality of bacterial meningitis in Aragón (Spain).
The clinical records of all the patients with bacterial meningitis seen in the hospitals in Aragón (Spain), from 1985 to 1988 inclusive were reviewed.
The mean of the annual rates of incidence for Aragón (Spain) was 7.52/100,000 inhabitants. In patients under the age of 15 years the most frequent etiologies were Neisseria meningitidis (59.0%), Haemophilus influenzae (13.7%) and Streptococcus pneumoniae (9.4%); the global rate of mortality was 3.5% similar to that of sequelae. In those over the age of 14 years, the most frequent etiologies were N. meningitidis (33%), S. pneumoniae (18.4%) and Staphylococcus spp. (13.6%); the rate of global mortality was 19.5% and that of sequelae 10.8% with resistance of S. pneumoniae to penicillin and/or ampicillin in 45.5% of the cases in children and in 26.3% in adults. No significant evolutive differences related with the existence of resistances or the administration of antibiotics prior to lumbar punction were observed in any of the age groups.
N. meningitidis is the main etiologic agent in Aragón in both children and adults. The greatest rates of mortality and sequelae were observed in the youngest and oldest age groups with a similar relation being seen in infection by gramnegative bacilli and S. pneumoniae, thus making these patients to be considered as being at high risk.
本研究旨在了解西班牙阿拉贡地区细菌性脑膜炎的发病率、病因、预后因素及死亡率。
回顾了1985年至1988年期间(含)在西班牙阿拉贡地区各医院就诊的所有细菌性脑膜炎患者的临床记录。
西班牙阿拉贡地区的年平均发病率为7.52/10万居民。15岁以下患者最常见的病因是脑膜炎奈瑟菌(59.0%)、流感嗜血杆菌(13.7%)和肺炎链球菌(9.4%);总体死亡率为3.5%,与后遗症发生率相似。14岁以上患者最常见的病因是脑膜炎奈瑟菌(33%)、肺炎链球菌(18.4%)和葡萄球菌属(13.6%);总体死亡率为19.5%,后遗症发生率为10.8%,儿童中45.5%的病例以及成人中26.3%的病例的肺炎链球菌对青霉素和/或氨苄西林耐药。在任何年龄组中,均未观察到与耐药性的存在或腰椎穿刺前使用抗生素有关的显著演变差异。
脑膜炎奈瑟菌是阿拉贡地区儿童和成人细菌性脑膜炎的主要病原体。最年幼和最年长年龄组的死亡率和后遗症发生率最高,革兰氏阴性杆菌和肺炎链球菌感染也呈现类似关系,因此这些患者被视为高危人群。