title: Epidemiology of invasive meningococcal disease in 13 government hospitals in Thailand, 1994-1999.
abstract: 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.
authors: Chulalongkorn University, Bangkok, Thailand. chadapanch@usa.net
authors: C
authors: C
authors: Pancharoen
authors: S
authors: S
authors: Hongsiriwon
authors: K
authors: K
authors: Swasdichai
authors: T
authors: T
authors: Puthanakit
authors: A
authors: A
authors: Tangsathapornpong
authors: S
authors: S
authors: Lolekha
authors: W
authors: W
authors: Punpanich
authors: U
authors: U
authors: Tarunotai
authors: B
authors: B
authors: Warachit
authors: J
authors: J
authors: Mekmullica
authors: P
authors: P
authors: Kosalaraksa
authors: K
authors: K
authors: Chokephaibulkit
authors: A
authors: A
authors: Kerdpanich
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D000667:Ampicillin; D002439:Cefotaxime; D010400:Penicillin G