The causative organisms of bacterial meningitis in Korean children in 1996-2005

Abstract

Bacterial meningitis remains a serious cause of morbidity and mortality in childhood, despite the availability of effective vaccines against Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae. The purpose of this study was to analyze data on bacterial meningitis cases in Korea from 1996 through 2005. The information of all hospitalized bacteria-proven meningitis cases was obtained from 17 university hospitals nationwide. A total of 402 cases were identified. Of these, 125 (29.9%) cases were neonates. Streptococcus agalactiae was the most common bacteria responsible for 99 (24.6%) of all cases regardless of age, followed by S. pneumoniae for 91 (22.6%) and H. influenzae for 67 (16.7%) patients. The common etiology beyond the neonatal period was S. pneumoniae for 91 (33.0%) followed by H. influenzae for 63 (22.8%) patients. The overall case fatality rate was 9.4%, which was similar with that in 1986-1995. In conclusion, S. agalactiae, S. pneumoniae and H. influenzae were important etiologic agents of bacterial meningitis in children in the last 10 yrs. It is required to establish the preventive strategy of the three bacteria. The nationwide epidemiologic study should be continued to evaluate immunization strategy and efficacy.

Keywords: Epidemiology; Etiology; Haemophilus influenzae; Meningitis, Bacterial; Neisseria meningitidis; Streptococcus agalactiae; Streptococcus pneumoniae.

Fig. 1

Yearly distribution of bacterial meningitis according to etiologic agents. The incidence of H. influenzae meningitis has markedly decreased since 2001. ^*The category "others" included coagulase negative Staphylococcus (26 cases, 6.5%), Streptococcus (other than S. agalactiae) (15 cases, 3.7%), Staphylococcus aureus (15 cases, 3.7%), Klebsiella pneumoniae (11 cases, 2.7%), Enterococcus species (10 cases, 2.5%), Enterobacter cloacae (5 cases, 1.2%), Salmonella species (4 cases, 1.0%), Acinetobacter species (4 cases, 1.0%), Listeria species (3 cases, 0.7%), Pseudomonas aeruginosa (3 cases, 0.7%), Mycobacterium tuberculosis, Proteus mirabilis, Flavobacterium indologans and Gramnegative bacilli.