Bacterial meningitis among cochlear implant recipients--Canada, 2002.
BACKGROUND
In July 2002, a cluster of bacterial meningitis (BM) cases was identified among European cochlear implant recipients (CIRs), prompting Health Canada to conduct a retrospective cohort study to determine the rate of BM infection among Canadian CIRs and to identify risk factors for acquiring BM.


METHODS
A survey was mailed to 1,432 Canadian CIRs who had received implants during January 1995-July 2002 to assess occurrence of postimplant BM infection. Data collection included demographics, episodes of meningitis, and vaccination status.


RESULTS
A total of 1,024 (72%) surveys were completed. Median age of CIRs at implantation was 16 years (range: 7 months-81 years). Five (0.5%) cases of BM infection were reported (two pneumococcal, one meningococcal, and two of unknown etiology); one CIR died. Four cases occurred among children aged <18 years. Time between implantation and BM infection varied (range: 7 months-7.7 years; median: 11 months). The rate of BM infection per 1,000 person-years was 0.7 among CIRs aged > or =18 years and 2.9 among those aged <18 years. The proportion of CIRs vaccinated against pneumococcal and meningococcal disease was low (46% and 41%, respectively). Preimplant meningitis was identified as a risk factor for postimplant BM (p = 0.002). No other risk factors evaluated were associated with an increased risk for BM infection.


CONCLUSIONS
CIRs have a high rate of postimplant BM infection. Preimplant BM infection was identified as a risk factor. Cases of BM infection might have been prevented through vaccination.
Wilson-Clark
Samantha D
SD
Immunization and Respiratory Infections Division, Public Health Agency of Canada, Ottawa, Canada. wsamanth@region.waterloo.on.ca
Squires
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Deeks
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D000293:Adolescent; D000328:Adult; D000368:Aged; D001428:Bacterial Vaccines; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D001428:Bacterial Vaccines