title: Bacterial meningitis post-PCV7: declining incidence and treatment.
abstract: The epidemiology of bacterial meningitis in the United States has changed tremendously in the past 20 years. Since the introduction of the Haemophilus influenzae type b vaccine in 1988, the incidence of H. influenzae type b meningitis has declined by at least 97%, and Streptococcus pneumoniae has emerged as the most common etiologic agent. The PCV7 (7-valent pneumococcal conjugate vaccine [Prevnar]; Wyeth Pharmaceuticals) vaccine, which targets 7 pneumococcal serotypes, was introduced in 2000 and has had an enormous impact on both the incidence and epidemiology of bacterial meningitis. This article reviews the impact of the PCV7 vaccine and the most up-to-date evidence on diagnosis and empiric therapy of suspected bacterial meningitis in the current day.
authors.affiliation: Departments of Pediatrics and Emergency Medicine, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10021, USA. rak9043@med.cornell.edu
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Kowalsky
authors.forename: David M
authors.initials: DM
authors.lastname: Jaffe
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000166:cytology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D024901:Drug Resistance, Multiple, Bacterial; D018073:Haemophilus Vaccines; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008582:Meningitis, Aseptic / Q000175:diagnosis; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D008583:Meningitis, Haemophilus / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D008586:Meningitis, Pneumococcal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D009017:Morbidity / Q000639:trends; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D022242:Pneumococcal Vaccines / Q000276:immunology; D011159:Population Surveillance; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000276:immunology; D063189:Symptom Assessment; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data; D064166:Vaccine Potency
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D018073:Haemophilus Vaccines; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines