Epidemiology of invasive meningococcal disease in 13 government hospitals in Thailand, 1994-1999.
This study was conducted to elucidate the magnitude of problem and the clinical course of invasive meningococcal infection from 13 government hospitals in Thailand between 1994 and 1999. Thirty-six strains of Neisseria meningitidis were isolated from 16 blood and 24 cerebrospinal fluid specimens; 4 patients had positive culture in both blood and CSF. Of the 16 strains, 9 (56.3%) were serogroup B. Seventy-one and eighty-four percent of the isolates were susceptible to penicillin and cefotaxime/ceftriaxone respectively. Five out of six penicillin-nonsusceptible strains were found to be relatively resistant to penicillin with the MIC of 0.125 microg/ml. Of 33 patients whose medical records were available, 21 were males and 12 were females, with a mean age of 11.2 years. Fifteen patients (45.5%) presented with meningococcemia and 18 patients (54.5%) presented with meningococcal meningitis. Hypotension and purpura were found in 24.2% and 33.3% of patients respectively. The overall mortality rate was 9.1%. In conclusion, meningococcal disease is not common in Thailand, meningococcemia is a life-threatening condition whereas meningococcal meningitis is much less severe. The prevalence of meningococci relatively resistant to penicillin seems to be increasing.
Pancharoen
C
C
Chulalongkorn University, Bangkok, Thailand. chadapanch@usa.net
Hongsiriwon
S
S
Swasdichai
K
K
Puthanakit
T
T
Tangsathapornpong
A
A
Lolekha
S
S
Punpanich
W
W
Tarunotai
U
U
Warachit
B
B
Mekmullica
J
J
Kosalaraksa
P
P
Chokephaibulkit
K
K
Kerdpanich
A
A
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002648:Child; D002701:Chloramphenicol / Q000627:therapeutic use; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008585:Meningitis, Meningococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D010400:Penicillin G / Q000627:therapeutic use; D013785:Thailand / Q000453:epidemiology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D000667:Ampicillin; D002439:Cefotaxime; D010400:Penicillin G