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Epidemiology of meningitis and bacteraemia due to Streptococcus pneumoniae in The Netherlands
Author(s) -
Spanjaard L,
Ende A,
Rümke H,
Dankert J,
Alphen L
Publication year - 2000
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2000.tb00778.x
Subject(s) - meningitis , streptococcus pneumoniae , medicine , incidence (geometry) , epidemiology , case fatality rate , serotype , penicillin , pediatrics , microbiology and biotechnology , antibiotics , immunology , biology , physics , optics
In The Netherlands, accurate data on the epidemiology of pneumococcal meningitis are available through a clinical microbiology laboratory‐based national surveillance of cerebrospinal fluid isolates. The Netherlands Reference Laboratory for Bacterial Meningitis receives isolates of about 80% of all meningitis cases and about 40% of bacteraemic cases. The incidence of pneumococcal meningitis has increased slowly from 1.0/1 in 1990 to 1.5/1 since 1996. The highest age‐specific incidence of meningitis was observed in children <5y of age (8.2/1 in 1999). Of all isolates, 35% were from children <5 y of age. The number of isolates from non‐meningitis patients with bacteraemia increased considerably since the early 1990s, especially among the elderly. The highest incidence was found in 1996, probably owing to a relatively severe winter. During 1995–1999, pneumococcal meningitis in The Netherlands was caused mainly by serotypes 3, 6B, 7F, 9V, 14, 18C, 19F, and 23F. Of the cases in children <15y, almost half were caused by serotypes 6B, 14, 18C, and 19F. The serotypes present in the 23‐valent polysaccharide and 7‐valent conjugate vaccines accounted for 87% and 47% of all meningitis cases, respectively. Pneumococcal resistance to penicillin in The Netherlands is still low, at about 1%. Genotypically, resistant strains belong to many clones. Horizontal transfer of capsular genes occurs among these isolates. In The Netherlands, 45% of cases of pneumococcal meningitis have severe predisposing factors. The case‐fatality rate was significantly higher among patients with impaired immunity than among those with a break in the integrity of the dura.