[Trends in pediatric bacterial meningitis in Japan (2003-2004)].
We surveyed the epidemiology of pediatric bacterial meningitis between January 2003 and December 2004 in Japan, with the following results: Bacterial meningitis cases numbered 233 (132 boys, 98 girls, and 3 unidentified), equivalent to 1.13-1.6 children of 1000 hospitalized in pediatrics per year. The age distribution for the infections was the highest under 1 year of age, decreasing with increasing age. Haemophilus influenzae was the most common pathogen, followed by Streptococcus pneumoniae, group B streptococcus, and Escherichia coli. The relationship between causactive pathogens and age distribution was as follows: group B. streptococcus and E. coli were major pathogens below 4 months of age and H. influenzae and S. pneumoniae were major pathogens above 4 months of age. Susceptibility tests at each facility demonstrated that 65.0% of H. influenzae isolates and 83.0% of S. pneumoniae isolates in 2004 were drug-resistant. Ampicillin and cephem antibiotics are currently effective against GBS, E. coli and Listeria so a combination of ampicillin and cephem antibiotics is used first line at many facilities for patients below 4 months of age. A combination of carbapenem which showed effective against PRSP and cephem which showed effective against H. influenzae is the first choice in childhood bacterial meningitis for patients above 4 months of age.
Sunakawa
Keisuke
K
Department of Infectious Diseases, Kitasato University School of Medicine.
Nonoyama
Masato
M
Ooishi
Tomohiro
T
Iwata
Satoshi
S
Akita
Hironobu
H
Sato
Yoshitake
Y
Ubukata
Kimiko
K
Chiba
Nahoko
N
Hasegawa
Keiko
K
D000667:Ampicillin / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
D002511:Cephalosporins; D000667:Ampicillin