Bacterial Meningitis in the United States in 1995

doi:10.1056/NEJM199710023371404

Volume 337:970-976		October 2, 1997		Number 14

Bacterial Meningitis in the United States in 1995

Anne Schuchat, M.D., Katherine Robinson, M.P.H., Jay D. Wenger, M.D., Lee H. Harrison, M.D., Monica Farley, M.D., Arthur L. Reingold, M.D., Lewis Lefkowitz, M.D., Bradley A. Perkins, M.D., for The Active Surveillance Team

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ABSTRACT

Background Before the introduction of the conjugate vaccines,Haemophilus influenzae type b was the major cause of bacterialmeningitis in the United States, and meningitis was primarilya disease of infants and young children. We describe the epidemiologicfeatures of bacterial meningitis five years after the H. influenzaetype b conjugate vaccines were licensed for routine immunizationof infants.

Methods Data were collected from active, population-based surveillancefor culture-confirmed meningitis and other invasive bacterialdisease during 1995 in laboratories serving all the acute carehospitals in 22 counties of four states (total population, morethan 10 million). The rates were compared with those for 1986obtained by similar surveillance.

Results On the basis of 248 cases of bacterial meningitis inthe surveillance areas, the rates of meningitis (per 100,000)for the major pathogens in 1995 were Streptococcus pneumoniae,1.1; Neisseria meningitidis, 0.6; group B streptococcus, 0.3;Listeria monocytogenes, 0.2; and H. influenzae, 0.2. Group Bstreptococcus was the predominant pathogen among newborns, N.meningitidis among children 2 to 18 years old, and S. pneumoniaeamong adults. Pneumococcal meningitis had the highest case fatalityrate (21 percent) and in 36 percent of cases was caused by organismsthat were not susceptible to penicillin. From these data, weestimate that 5755 cases of bacterial meningitis were causedby these five pathogens in the United States in 1995, as comparedwith 12,920 cases in 1986, a reduction of 55 percent. The medianage of persons with bacterial meningitis increased greatly,from 15 months in 1986 to 25 years in 1995, largely as a resultof a 94 percent reduction in the number of cases of H. influenzaemeningitis.

Conclusions Because of the vaccine-related decline in meningitisdue to H. influenzae type b, bacterial meningitis in the UnitedStates is now a disease predominantly of adults rather thanof infants and young children.

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From the Respiratory Diseases Branch (A.S., K.R., J.D.W.) and the Meningitis and Special Pathogens Branch (B.A.P.), Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta; Johns Hopkins School of Hygiene and Public Health, Baltimore (L.H.H.); Veterans Affairs Medical Services and Emory University School of Medicine, Atlanta (M.F.); the California Emerging Infections Program, Berkeley (A.L.R.); and Vanderbilt Medical Center, Nashville (L.L.).

Address reprint requests to Dr. Schuchat at Mailstop C-23, Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333.

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O'Brien, K. L., Santosham, M. (2004). Potential Impact of Conjugate Pneumococcal Vaccines on Pediatric Pneumococcal Diseases. Am J Epidemiol 159: 634-644 [Abstract] [Full Text]
Anderson, V., Anderson, P., Grimwood, K., Nolan, T. (2004). Cognitive and Executive Function 12 Years after Childhood Bacterial Meningitis: Effect of Acute Neurologic Complications and Age of Onset. J Pediatr Psychol 29: 67-81 [Abstract] [Full Text]
Kaplan, S. L., Mason, E. O Jr, Wald, E. R., Schutze, G. E., Bradley, J. S., Tan, T. Q., Hoffman, J. A., Givner, L. B., Yogev, R., Barson, W. J. (2004). Decrease of Invasive Pneumococcal Infections in Children Among 8 Children's Hospitals in the United States After the Introduction of the 7-Valent Pneumococcal Conjugate Vaccine. Pediatrics 113: 443-449 [Abstract] [Full Text]
Hemsley, C., Joyce, E., Hava, D. L., Kawale, A., Camilli, A. (2003). MgrA, an Orthologue of Mga, Acts as a Transcriptional Repressor of the Genes within the rlrA Pathogenicity Islet in Streptococcus pneumoniae. J. Bacteriol. 185: 6640-6647 [Abstract] [Full Text]
Finkelstein, J. A., Huang, S. S., Daniel, J., Rifas-Shiman, S. L., Kleinman, K., Goldmann, D., Pelton, S. I., DeMaria, A., Platt, R. (2003). Antibiotic-Resistant Streptococcus pneumoniae in the Heptavalent Pneumococcal Conjugate Vaccine Era: Predictors of Carriage in a Multicommunity Sample. Pediatrics 112: 862-869 [Abstract] [Full Text]
Richardson, D. C., Louie, L., Louie, M., Simor, A. E. (2003). Evaluation of a Rapid PCR Assay for Diagnosis of Meningococcal Meningitis. J. Clin. Microbiol. 41: 3851-3853 [Abstract] [Full Text]
de Andrade, A. L. S. S., Pimenta, F. C., Brandileone, M. C. C., Laval, C. A., Guerra, M. L., de Andrade, J. G., Di Fabio, J. L. (2003). Genetic Relationship between Streptococcus pneumoniae Isolates from Nasopharyngeal and Cerebrospinal Fluid of Two Infants with Pneumococcal Meningitis. J. Clin. Microbiol. 41: 3970-3972 [Abstract] [Full Text]
Reefhuis, J., Honein, M. A., Whitney, C. G., Chamany, S., Mann, E. A., Biernath, K. R., Broder, K., Manning, S., Avashia, S., Victor, M., Costa, P., Devine, O., Graham, A., Boyle, C. (2003). Risk of Bacterial Meningitis in Children with Cochlear Implants. NEJM 349: 435-445 [Abstract] [Full Text]
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Ortega, M., Marco, F., Soriano, A., Garcia, E., Martinez, J. A., Mensa, J. (2003). Lack of Vancomycin Tolerance in Streptococcus pneumoniae Strains Isolated in Barcelona, Spain, from 1999 to 2001. Antimicrob. Agents Chemother. 47: 1976-1978 [Abstract] [Full Text]
Davis, L. E., Greenlee, J. E. (2003). Pneumococcal meningitis: antibiotics essential but insufficient. Brain 126: 1013-1014 [Full Text]
Kastenbauer, S., Pfister, H.-W. (2003). Pneumococcal meningitis in adults: Spectrum of complications and prognostic factors in a series of 87 cases. Brain 126: 1015-1025 [Abstract] [Full Text]
Artz, A. S., Ershler, W. B., Longo, D. L. (2003). Pneumococcal Vaccination and Revaccination of Older Adults. Clin. Microbiol. Rev. 16: 308-318 [Abstract] [Full Text]
Lee, P.-Y., Chang, W.-N., Lu, C.-H., Lin, M.-W., Cheng, B.-C., Chien, C.-C., Chang, C.-J., Chang, H.-W. (2003). Clinical features and in vitro antimicrobial susceptibilities of community-acquired Klebsiella pneumoniae meningitis in Taiwan. J Antimicrob Chemother 51: 957-962 [Abstract] [Full Text]
Martin, M., Turco, J. H., Zegans, M. E., Facklam, R. R., Sodha, S., Elliott, J. A., Pryor, J. H., Beall, B., Erdman, D. D., Baumgartner, Y. Y., Sanchez, P. A., Schwartzman, J. D., Montero, J., Schuchat, A., Whitney, C. G. (2003). An Outbreak of Conjunctivitis Due to Atypical Streptococcus pneumoniae. NEJM 348: 1112-1121 [Abstract] [Full Text]
Wooltorton, E. (2003). Meningitis and cochlear implantation. CMAJ 168: 257-257 [Full Text]
Papsin, B. C. (2003). Meningitis and cochlear implantation. CMAJ 168: 256-257 [Full Text]
Koedel, U., Angele, B., Rupprecht, T., Wagner, H., Roggenkamp, A., Pfister, H.-W., Kirschning, C. J. (2003). Toll-Like Receptor 2 Participates in Mediation of Immune Response in Experimental Pneumococcal Meningitis. J. Immunol. 170: 438-444 [Abstract] [Full Text]
Noreddin, A. M., Roberts, D., Nichol, K., Wierzbowski, A., Hoban, D. J., Zhanel, G. G. (2002). Pharmacodynamic Modeling of Clarithromycin against Macrolide-Resistant [PCR-Positive mef(A) or erm(B)] Streptococcus pneumoniae Simulating Clinically Achievable Serum and Epithelial Lining Fluid Free-Drug Concentrations. Antimicrob. Agents Chemother. 46: 4029-4034 [Abstract] [Full Text]
Tunkel, A. R., Scheld, W. M. (2002). Corticosteroids for Everyone with Meningitis?. NEJM 347: 1613-1615 [Full Text]
Greiner, O., Berger, C., Day, P. J. R., Meier, G., Tang, C. M., Nadal, D. (2002). Rates of Detection of Neisseria meningitidis in Tonsils Differ in Relation to Local Incidence of Invasive Disease. J. Clin. Microbiol. 40: 3917-3921 [Abstract] [Full Text]
Nigrovic, L. E., Kuppermann, N., Malley, R. (2002). Development and Validation of a Multivariable Predictive Model to Distinguish Bacterial From Aseptic Meningitis in Children in the Post-Haemophilus influenzae Era. Pediatrics 110: 712-719 [Abstract] [Full Text]
Takahata, M., Yamada, H., Morita, T., Furubou, S., Minami, S., Todo, Y., Watanabe, Y., Narita, H. (2002). Evaluation of T-3811ME (BMS-284756), a New Des-F(6)-Quinolone, for Treatment of Meningitis Caused by Penicillin-Resistant Streptococcus pneumoniae in Rabbits. Antimicrob. Agents Chemother. 46: 1760-1765 [Abstract] [Full Text]
van de Beek, D., de Gans, J., Spanjaard, L., Vermeulen, M., Dankert, J. (2002). Antibiotic guidelines and antibiotic use in adult bacterial meningitis in The Netherlands. J Antimicrob Chemother 49: 661-666 [Abstract] [Full Text]
AUBURTIN, M., PORCHER, R., BRUNEEL, F., SCANVIC, A., TROUILLET, J. L., BEDOS, J. P., REGNIER, B., WOLFF, M. (2002). Pneumococcal Meningitis in the Intensive Care Unit . Prognostic Factors of Clinical Outcome in a Series of 80 Cases. Am. J. Respir. Crit. Care Med. 165: 713-717 [Abstract] [Full Text]
Pfister, H., Remer, K. A., Brcic, M., Fatzer, R., Christen, S., Leib, S., Jungi, T. W. (2002). Inducible Nitric Oxide Synthase and Nitrotyrosine in Listeric Encephalitis: A Cross-species Study in Ruminants. Vet Pathol 39: 190-199 [Abstract] [Full Text]
Tang, Y.-W., Li, H., Griffin, J. P., Haas, D. W., D'Agata, E. M. C. (2002). Rapidly Increasing Prevalence of Penicillin-Resistant Streptococcuspneumoniae in Middle Tennessee: a 10-Year Clinical and Molecular Analysis. J. Clin. Microbiol. 40: 395-399 [Abstract] [Full Text]
Kearns, A. M., Graham, C., Burdess, D., Heatherington, J., Freeman, R. (2002). Rapid Real-Time PCR for Determination of Penicillin Susceptibility in Pneumococcal Meningitis, Including Culture-Negative Cases. J. Clin. Microbiol. 40: 682-684 [Abstract] [Full Text]
Freedman, S. B., Marrocco, A., Pirie, J., Dick, P. T. (2001). Predictors of Bacterial Meningitis in the Era After Haemophilus influenzae. Arch Pediatr Adolesc Med 155: 1301-1306 [Abstract] [Full Text]
Rodriguez-Cerrato, V., Ghaffar, F., Saavedra, J., Michelow, I. C., Hardy, R. D., Iglehart, J., Olsen, K., McCracken, G. H. Jr. (2001). BMS-284756 in Experimental Cephalosporin-Resistant Pneumococcal Meningitis. Antimicrob. Agents Chemother. 45: 3098-3103 [Abstract] [Full Text]
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Lee, G. M., Fleisher, G. R., Harper, M. B. (2001). Management of Febrile Children in the Age of the Conjugate Pneumococcal Vaccine: A Cost-Effectiveness Analysis. Pediatrics 108: 835-844 [Abstract] [Full Text]
Grimwood, K. (2001). Legacy of bacterial meningitis in infancy. BMJ 323: 523-524 [Full Text]
Greiner, O., Day, P. J. R., Bosshard, P. P., Imeri, F., Altwegg, M., Nadal, D. (2001). Quantitative Detection of Streptococcus pneumoniae in Nasopharyngeal Secretions by Real-Time PCR. J. Clin. Microbiol. 39: 3129-3134 [Abstract] [Full Text]
Bruce, M. G., Rosenstein, N. E., Capparella, J. M., Shutt, K. A., Perkins, B. A., Collins, M. (2001). Risk Factors for Meningococcal Disease in College Students. JAMA 286: 688-693 [Abstract] [Full Text]
Harrison, L. H., Pass, M. A., Mendelsohn, A. B., Egri, M., Rosenstein, N. E., Bustamante, A., Razeq, J., Roche, J. C. (2001). Invasive Meningococcal Disease in Adolescents and Young Adults. JAMA 286: 694-699 [Abstract] [Full Text]
Vazquez-Boland, J. A., Kuhn, M., Berche, P., Chakraborty, T., Dominguez-Bernal, G., Goebel, W., Gonzalez-Zorn, B., Wehland, J., Kreft, J. (2001). Listeria Pathogenesis and Molecular Virulence Determinants. Clin. Microbiol. Rev. 14: 584-640 [Abstract] [Full Text]
Anton, N., Blazquez, R., Gomez-Garces, J. L., Alos, J. I. (2001). Study of vancomycin tolerance in 120 strains of Streptococcus pneumoniae isolated in 1999 in Madrid, Spain. J Antimicrob Chemother 47: 902-903 [Full Text]
Remer, K. A., Jungi, T. W., Fatzer, R., Tauber, M. G., Leib, S. L. (2001). Nitric Oxide Is Protective in Listeric Meningoencephalitis of Rats. Infect. Immun. 69: 4086-4093 [Abstract] [Full Text]
Francis, K. P., Yu, J., Bellinger-Kawahara, C., Joh, D., Hawkinson, M. J., Xiao, G., Purchio, T. F., Caparon, M. G., Lipsitch, M., Contag, P. R. (2001). Visualizing Pneumococcal Infections in the Lungs of Live Mice Using Bioluminescent Streptococcus pneumoniae Transformed with a Novel Gram-Positive lux Transposon. Infect. Immun. 69: 3350-3358 [Abstract] [Full Text]
Robinson, K. A., Baughman, W., Rothrock, G., Barrett, N. L., Pass, M., Lexau, C., Damaske, B., Stefonek, K., Barnes, B., Patterson, J., Zell, E. R., Schuchat, A., Whitney, C. G., for the Active Bacterial Core Surveillance /Emergi, (2001). Epidemiology of Invasive Streptococcus pneumoniae Infections in the United States, 1995-1998: Opportunities for Prevention in the Conjugate Vaccine Era. JAMA 285: 1729-1735 [Abstract] [Full Text]
O'Brien, K. L., Bronsdon, M. A., Dagan, R., Yagupsky, P., Janco, J., Elliott, J., Whitney, C. G., Yang, Y.-H., Robinson, L.-G. E., Schwartz, B., Carlone, G. M. (2001). Evaluation of a Medium (STGG) for Transport and Optimal Recovery of Streptococcus pneumoniae from Nasopharyngeal Secretions Collected during Field Studies. J. Clin. Microbiol. 39: 1021-1024 [Abstract] [Full Text]
WANG, C.-C., SIU, L.K., CHEN, M.-K., YU, Y.-L., LIN, F.M., HO, M., CHU, M.-L. (2001). Use of automated riboprinter and pulsed-field gel electrophoresis for epidemiological studies of invasive Haemophilus influenzae in Taiwan. J Med Microbiol 50: 277-283 [Abstract] [Full Text]
Zysk, G., Schneider-Wald, B. K., Hwang, J. H., Bejo, L., Kim, K. S., Mitchell, T. J., Hakenbeck, R., Heinz, H.-P. (2001). Pneumolysin Is the Main Inducer of Cytotoxicity to Brain Microvascular Endothelial Cells Caused by Streptococcus pneumoniae. Infect. Immun. 69: 845-852 [Abstract] [Full Text]
Whitney, C. G., Farley, M. M., Hadler, J., Harrison, L. H., Lexau, C., Reingold, A., Lefkowitz, L., Cieslak, P. R., Cetron, M., Zell, E. R., Jorgensen, J. H., Schuchat, A., The Active Bacterial Core Surveillance Program of, (2000). Increasing Prevalence of Multidrug-Resistant Streptococcus pneumoniae in the United States. NEJM 343: 1917-1924 [Abstract] [Full Text]
Cubbon, M. D., Masterton, R. G. (2000). New quinolones--a fresh answer to the pneumococcus. J Antimicrob Chemother 46: 869-872 [Full Text]
Gosink, K. K., Mann, E. R., Guglielmo, C., Tuomanen, E. I., Masure, H. R. (2000). Role of Novel Choline Binding Proteins in Virulence of Streptococcus pneumoniae. Infect. Immun. 68: 5690-5695 [Abstract] [Full Text]
Goldfine, H., Wadsworth, S. J., Johnston, N. C. (2000). Activation of Host Phospholipases C and D in Macrophages after Infection with Listeria monocytogenes. Infect. Immun. 68: 5735-5741 [Abstract] [Full Text]
Alpern, E. R., Alessandrini, E. A., Bell, L. M., Shaw, K. N., McGowan, K. L. (2000). Occult Bacteremia From a Pediatric Emergency Department: Current Prevalence, Time to Detection, and Outcome. Pediatrics 106: 505-511 [Abstract] [Full Text]

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