title: [Changes in bacterial meningitis in French children resulting from vaccination].
abstract: BACKGROUND
  For the past 20 years, three vaccines against the three main bacterial species implicated in meningitis in children have been included in the French vaccine calendar: Haemophilus influenzae b in 1993, 7-valent pneumococcal conjugate vaccine (PCV7) in 2003 (replaced by 13-valent in 2010) and Neisseria meningitidis C in 2009. The French active surveillance network from the GPIP/ACTIV monitors the change in the epidemiological, clinical, and biological features of bacterial meningitis due to vaccine use.
  
  
  METHODS
  Over a 12-year period, 233 pediatric wards working with 168 microbiology departments throughout France were asked to report all cases of bacterial meningitis.
  
  
  RESULTS
  From January 2001 to December 2012, 4808 bacterial meningitis cases were reported. Between 2001 and 2012, the number of pneumococcal meningitis (PM) cases decreased by 23.4%, and by 32.2% for children less than 2 years old. During this period, the proportion of cases attributable to PCV7 and six additional PCV13 types decreased from 63.3% to 8.1% and 83.7% to 32.4%, respectively. In 2012, the main vaccine types (accounting for 25.8% of cases) were 7F (12.2%), 19A (6.8%), and 19F (6.8%), and the most frequent non-vaccine types were 12F (14.9%), 24F (14.9%), 15B/C (6.8%), 22F (6.8%), and 10A (5.4%). In 2012, the rate of strains with decreased susceptibility to cefotaxime/ceftriaxone (MIC>0.5 μg/mL) represented less than 3% of cases, with no identified resistant strain since 2010 (MIC>2 μg/mL). Between 2001 (n=67) and 2012 (n=9), the number of NmC meningitis cases decreased by 87%.
  
  
  CONCLUSIONS
  With more than 4800 bacterial meningitis cases reported in 12 years, this nationwide survey provides essential information on the microbiological and clinical characteristics of bacterial meningitis (epidemiology or resistance data). These results could lead to changing antibiotic treatment of pneumococcal meningitis before the results of antibiotic susceptibility tests.
authors.affiliation: Groupe de pathologie infectieuse pédiatrique de la Société française de pédiatrie, 75014 Paris, France; Association clinique et thérapeutique infantile du Val-de-Marne, 27, rue Inkermann, 94100 St-Maur-des-Fossés, France; CRC, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 91010 Créteil cedex, France. Electronic address: corinne.levy@activfrance.fr.
authors.forename: C
authors.initials: C
authors.lastname: Levy
authors.affiliation: Centre national de référence des pneumocoques, hôpital européen Georges-Pompidou, université Paris 5, AP-HP, 75015 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Varon
authors.affiliation: Institut Pasteur, CNRM, 75015 Paris, France.
authors.forename: M-K
authors.initials: MK
authors.lastname: Taha
authors.affiliation: Association clinique et thérapeutique infantile du Val-de-Marne, 27, rue Inkermann, 94100 St-Maur-des-Fossés, France.
authors.forename: S
authors.initials: S
authors.lastname: Béchet
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, EA 3105, 12 laboratoire de microbiologie, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, Paris, France; Service de microbiologie, hôpital Robert-Debré, 75019 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Bonacorsi
authors.affiliation: Groupe de pathologie infectieuse pédiatrique de la Société française de pédiatrie, 75014 Paris, France; Association clinique et thérapeutique infantile du Val-de-Marne, 27, rue Inkermann, 94100 St-Maur-des-Fossés, France; CRC, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 91010 Créteil cedex, France; Service de néonatologie, unité court séjour, petits nourrissons, centre hospitalier intercommunal de Créteil, 94000 Créteil, France.
authors.forename: R
authors.initials: R
authors.lastname: Cohen
authors.affiliation: Groupe de pathologie infectieuse pédiatrique de la Société française de pédiatrie, 75014 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, EA 3105, 12 laboratoire de microbiologie, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, Paris, France; Service de microbiologie, hôpital Robert-Debré, 75019 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Bingen
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001428:Bacterial Vaccines / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D001428:Bacterial Vaccines