Berg S, Trollfors B, Claesson B A, Alestig K, Gothefors L, Hugosson S, Lindquist L, Olcén P, Romanus V, Strangert K
Department of Paediatrics, Mölndal Hospital, Sweden.
Scand J Infect Dis. 1996;28(3):247-52. doi: 10.3109/00365549609027166.
The incidence, concomitant conditions and case fatality rate of Haemophilus influenzae (Hi) and pneumococcal meningitis and of invasive meningococcal infections were studied retrospectively in Sweden (population 8.4 million) for the years 1987-89, the period before vaccination against Hi type b started. A total of 1,019 cases with culture-verified infection were found. The incidence rates per 100,000 per year were 1.8 for Hi meningitis, 1.2 for pneumococcal meningitis and 1.0 for invasive meningococcal infections. The age-specific incidence was highest in the 3-23 months age group for the 3 bacterial species. Pneumococcal meningitis was common in individuals > or = 60 years and meningococcal infections in the age-group 10-24 years. A serious concomitant condition was known in 57% of all patients with pneumococcal meningitis while this was uncommon for the other organisms. The case fatality rate was 2% for Hi meningitis, 24% for pneumococcal meningitis and 10% for meningococcal infections. All 81 pneumococcal isolates which had been serotyped belonged to serotypes in the 23-valent pneumococcal vaccine. Of the meningococcal isolates, 65% belonged to serogroup B. In conclusion, the high incidence of Hib meningitis justifies general Hib vaccination. Development of a vaccine against N. meningitidis group B should have high priority. Furthermore, improved pneumococcal vaccines are needed for patients with predisposing conditions. The currently available pneumococcal polysaccharide vaccine seems to be underused.
1987 - 1989年，在瑞典（人口840万），即在开始接种b型流感嗜血杆菌疫苗之前的这段时期，对流感嗜血杆菌（Hi）、肺炎球菌性脑膜炎以及侵袭性脑膜炎球菌感染的发病率、伴随疾病和病死率进行了回顾性研究。共发现1019例经培养证实的感染病例。每年每10万人中的发病率分别为：Hi脑膜炎1.8例、肺炎球菌性脑膜炎1.2例、侵袭性脑膜炎球菌感染1.0例。这3种细菌在3 - 23个月年龄组的年龄特异性发病率最高。肺炎球菌性脑膜炎在≥60岁的个体中常见，而脑膜炎球菌感染在10 - 24岁年龄组中常见。在所有肺炎球菌性脑膜炎患者中，57%已知有严重的伴随疾病，而其他病原体感染患者中这种情况并不常见。Hi脑膜炎的病死率为2%，肺炎球菌性脑膜炎为24%，脑膜炎球菌感染为10%。所有81株已进行血清分型的肺炎球菌分离株均属于23价肺炎球菌疫苗中的血清型。在脑膜炎球菌分离株中，65%属于B血清群。总之，Hib脑膜炎的高发病率证明了普遍接种Hib疫苗的合理性。开发针对B群脑膜炎奈瑟菌的疫苗应具有高度优先性。此外，对于有易感因素的患者，需要改进肺炎球菌疫苗。目前可用的肺炎球菌多糖疫苗似乎未得到充分利用。
