Etiology and mortality of bacterial meningitis in northeastern Brazil.
Etiology and mortality of bacterial meningitis in northeastern Brazil.
复制标题
巴西东北部细菌性脑膜炎的病因和死亡率。
DOI：
10.1093/clinids/12.1.128
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Scheld,WM
中科院分区：
文献类型：
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作者：
Bryan,JP;deSilva,HR;Tavares,A;Rocha,H;Scheld,WM
目前对发展中国家，特别是拉丁美洲脑膜炎的发病率和死亡率知之甚少。我们回顾了1973 - 1982年巴西萨尔瓦多一家隔离发热医院的所有脑膜炎病例。在所有入院病例中，6，751例（27%）为脑膜炎，其中4，100例（61%）为明确或可能的细菌性病因。15岁以下儿童占病例的79%，45%的病例为2岁以下儿童。总病死率为33%，其中50%的死亡发生在住院后48小时内，32%的病例的病原体为脑膜炎奈瑟菌，病死率为14%。由N. 1974-1978年C群脑膜炎占60%，其次为A群，肺炎链球菌占17%，病死率为59%，非流行性脑膜炎最常见的致病菌为流感嗜血杆菌B型，占23%，病死率为38%，肠杆菌仅占3.6%。但病死率为86%。18%的脓性脑脊液培养阴性。H.流感嗜血杆菌占40%。pneumoniae、Enterobacteriaceae和N.脑膜炎发生在2岁以下的儿童中。这一组的病死率最高。因此，迫切需要针对这一年龄段人群的疫苗。
Little is known of the current incidence and mortality of meningitis in developing nations, especially in Latin America. We reviewed all cases of meningitis in an isolation-fever hospital in Salvador, Brazil, for the decade 1973–1982. Of all admissions, 6,751(27%) were for meningitis; 4,100 (61%) of these cases were of definite or probable bacterial etiology. Children younger than 15 years accounted for 79% of cases, and 45% of cases were in children under 2 years. The overall case fatality rate was 33%, with 50% of these deaths occurring within 48 hours of hospitalization.Neisseria meningitidiswas the etiologic agent in 32% of the cases, with a case fatality rate of 14%. Epidemics caused byN. meningitidisgroup C, then group A, in 1974–1978 accounted for 60% of the cases.Streptococcus pneumoniaecaused 17% of cases, with a case fatality rate of 59%.Haemophilus influenzaetype b, the most common cause of nonepidemic meningitis, caused 23% of all cases, with a case fatality rate of 38%.Enterobacteriaceaewere the etiology in only 3.6% of patients, but the case fatality rate was 86%. Cultures were negative in 18% of cases with purulent cerebrospinal fluid. A total of 84% ofH. influenzae, 40% ofS. pneumoniae, 78% ofEnterobacteriaceae, and 15% ofN. meningitidiscases occurred in children less than 2 years of age. Case fatality rates were highest in this group. Vaccines protective for this age group are urgently needed.