학술논문

Pneumococcal Meningitis in Adults after Introduction of PCV7 and PCV13, Israel, July 2009-June 20151.
Document Type
Journal Article
Source
Emerging Infectious Diseases. Jul2018, Vol. 24 Issue 7, p1275-1284. 10p. 4 Charts, 5 Graphs.
Subject
*PNEUMOCOCCAL meningitis
*ANTIBODY-drug conjugates
*VACCINES
*DISEASE incidence
*HEAD surgery
*CEREBROSPINAL fluid
*MENINGOCOCCAL vaccines
Language
ISSN
1080-6040
Abstract
The indirect effect of pneumococcal conjugate vaccine on adult pneumococcal meningitis has not been thoroughly investigated. We present data from active surveillance on pneumococcal meningitis in adults in Israel occurring during July 2009-June 2015. Pneumococcal meningitis was diagnosed for 221 patients, 9.4% of all invasive pneumococcal disease (IPD) cases. Although overall IPD incidence decreased during the study period, meningitis increased nonsignificantly from 0.66 to 0.85 cases/100,000 population. Incidence of vaccine type (VT) pneumococcal meningitis (VT13) decreased by 70%, but non-VT13 pneumococcal meningitis increased from 0.32 to 0.75 cases/100,000 population (incident rate ratio 2.35, 95% CI 1.27-4.35). Pneumococcal meningitis patients were younger and healthier than nonmeningitis IPD patients, and 20.2% had a history of previous head surgery or cerebrospinal fluid leak compared with <2.0% of nonmeningitis patients (p<0.0001). Non-VT13 types that rarely cause IPD (15B/C, 6C, 23A, 23B, 24F) seem to be emerging as common causes of meningitis. [ABSTRACT FROM AUTHOR]