title: Bacterial agents causing meningitis during 2013-2014 in Turkey: A multi-center hospital-based prospective surveillance study.
abstract: This is an observational epidemiological study to describe causes of bacterial meningitis among persons between 1 month and 18 y of age who are hospitalized with suspected bacterial meningitis in 7 Turkish regions. covering 32% of the entire population of Turkey. We present here the results from 2013 and 2014. A clinical case with meningitis was defined according to followings: any sign of meningitis including fever, vomiting, headache, and meningeal irritation in children above one year of age and fever without any documented source, impaired consciousness, prostration and seizures in those < 1 y of age. Single tube multiplex PCR assay was performed for the simultaneous identification of bacterial agents. The specific gene targets were ctrA, bex, and ply for N. meningitidis, Hib, and S. pneumoniae, respectively. PCR positive samples were recorded as laboratory-confirmed acute bacterial meningitis. A total of 665 children were hospitalized for suspected acute meningitis. The annual incidences of acute laboratory-confirmed bacterial meningitis were 0.3 cases / 100,000 population in 2013 and 0.9 cases/100,000 in 2014. Of the 94 diagnosed cases of bacterial meningitis by PCR, 85 (90.4%) were meningococcal and 9 (9.6%) were pneumococcal. Hib was not detected in any of the patients. Among meningococcal meningitis, cases of serogroup Y, A, B and W-135 were 2.4% (n = 2), 3.5% (n = 3), 32.9% (n = 28), and 42.4% (n = 36). No serogroup C was detected among meningococcal cases. Successful vaccination policies for protection from bacterial meningitis are dependent on accurate determination of the etiology of bacterial meningitis. Additionally, the epidemiology of meningococcal disease is dynamic and close monitoring of serogroup distribution is comprehensively needed to assess the benefit of adding meningococcal vaccines to the routine immunization program.
authors.affiliation: a Department of Pediatric Infectious Diseases , Hacettepe University Faculty of Medicine , Ankara , Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ceyhan
authors.affiliation: a Department of Pediatric Infectious Diseases , Hacettepe University Faculty of Medicine , Ankara , Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozsurekci
authors.affiliation: b Department of Microbiology and Clinical Microbiology , Istanbul University Faculty of Medicine , Istanbul , Turkey.
authors.forename: Nezahat
authors.initials: N
authors.lastname: Gürler
authors.affiliation: a Department of Pediatric Infectious Diseases , Hacettepe University Faculty of Medicine , Ankara , Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Karadag Oncel
authors.affiliation: c Department of Pediatrics , Istanbul University, Cerrahpasa Faculty of Medicine , Istanbul , Turkey.
authors.forename: Yıldız
authors.initials: Y
authors.lastname: Camcioglu
authors.affiliation: d Department of Pediatrics , Istanbul University Faculty of Medicine , Istanbul , Turkey.
authors.forename: Nuran
authors.initials: N
authors.lastname: Salman
authors.affiliation: e Sanliurfa State Hospital , Sanliurfa , Turkey.
authors.forename: Melda
authors.initials: M
authors.lastname: Celik
authors.affiliation: f Department of Pediatrics , Selcuk University Meram Faculty of Medicine , Konya , Turkey.
authors.forename: Melike Keser
authors.initials: MK
authors.lastname: Emiroglu
authors.affiliation: g Department of Pediatrics , Konya Training and Research Hospital , Konya , Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Akin
authors.affiliation: h Department of Pediatric Infectious Diseases , Gazi University Faculty of Medicine , Ankara , Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Tezer
authors.affiliation: i Ankara Hematology Oncology Children's Training and Research Hospital , Ankara , Turkey.
authors.forename: Aslinur Ozkaya
authors.initials: AO
authors.lastname: Parlakay
authors.affiliation: j Microbiology Laboratory , Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital , Ankara , Turkey.
authors.forename: Nilden
authors.initials: N
authors.lastname: Tuygun
authors.affiliation: k Department of Pediatrics , Akdeniz University Faculty of Medicine , Antalya , Turkey.
authors.forename: Diyar
authors.initials: D
authors.lastname: Tamburaci
authors.affiliation: l Department of Pediatrics , Osmangazi University Faculty of Medicine , Eskisehir , Turkey.
authors.forename: Ener Cagri
authors.initials: EC
authors.lastname: Dinleyici
authors.affiliation: m Okmeydani State Hospital , Istanbul , Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Karbuz
authors.affiliation: n Department of Pediatrics , Dicle University Faculty of Medicine , Diyarbakir , Turkey.
authors.forename: Ünal
authors.initials: Ü
authors.lastname: Uluca
authors.affiliation: o Department of Pediatrics , Cukurova University Faculty of Medicine , Adana , Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Alhan
authors.affiliation: o Department of Pediatrics , Cukurova University Faculty of Medicine , Adana , Turkey.
authors.forename: Ümmühan
authors.initials: Ü
authors.lastname: Çay
authors.affiliation: p Department of Pediatrics , Ege University Faculty of Medicine , Izmir , Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kurugol
authors.affiliation: q Department of Pediatrics , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Nevin
authors.initials: N
authors.lastname: Hatipoğlu
authors.affiliation: q Department of Pediatrics , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Rengin
authors.initials: R
authors.lastname: Şiraneci
authors.affiliation: r Department of Pediatrics , Tepecik Training and Research Hospital , Izmir , Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: İnce
authors.affiliation: s Department of Pediatric Infectious Diseases , Ondokuz Mayis University Faculty of Medicine , Samsun , Turkey.
authors.forename: Gülnar
authors.initials: G
authors.lastname: Sensoy
authors.affiliation: s Department of Pediatric Infectious Diseases , Ondokuz Mayis University Faculty of Medicine , Samsun , Turkey.
authors.forename: Nursen
authors.initials: N
authors.lastname: Belet
authors.affiliation: t Department of Pediatrics , Gaziantep University Faculty of Medicine , Gaziantep , Turkey.
authors.forename: Enes
authors.initials: E
authors.lastname: Coskun
authors.affiliation: t Department of Pediatrics , Gaziantep University Faculty of Medicine , Gaziantep , Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yilmaz
authors.affiliation: u Department of Pediatric Infectious Diseases , Uludag University Faculty of Medicine , Bursa , Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hacimustafaoglu
authors.affiliation: u Department of Pediatric Infectious Diseases , Uludag University Faculty of Medicine , Bursa , Turkey.
authors.forename: Solmaz
authors.initials: S
authors.lastname: Celebi
authors.affiliation: v Adana Numune Training and Research Hospital , Adana , Turkey.
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Celik
authors.affiliation: w Department of Pediatrics , Suleyman Demirel University Faculty of Medicine , Isparta , Turkey.
authors.forename: Metehan
authors.initials: M
authors.lastname: Ozen
authors.affiliation: w Department of Pediatrics , Suleyman Demirel University Faculty of Medicine , Isparta , Turkey.
authors.forename: Aybüke
authors.initials: A
authors.lastname: Akaslan
authors.affiliation: x Dr. Behcet Uz Children's Training and Research Hospital , Izmir , Turkey.
authors.forename: İlker
authors.initials: İ
authors.lastname: Devrim
authors.affiliation: y Department of Pediatric Infectious Diseases , Mersin University Faculty of Medicine , Mersin , Turkey.
authors.forename: Necdet
authors.initials: N
authors.lastname: Kuyucu
authors.affiliation: z Department of Pediatrics , Elazig University Faculty of Medicine , Elazig , Turkey.
authors.forename: Fatmanur
authors.initials: F
authors.lastname: Öz
authors.affiliation: aa Department of Pediatrics , Kayseri Training and Research Hospital , Kayseri , Turkey.
authors.forename: Sefika Elmas
authors.initials: SE
authors.lastname: Bozdemir
authors.affiliation: x Dr. Behcet Uz Children's Training and Research Hospital , Izmir , Turkey.
authors.forename: Ahu
authors.initials: A
authors.lastname: Kara
mesh_terms: D000293:Adolescent; D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D014421:Turkey / Q000453:epidemiology
keywords: Meningitis; Turkey; epidemiology; etiologic agents; hospital surveillance