Subbarao, S; Ribeiro, S; Campbell, H; Okike, I; Ramsay, ME; Ladhani, SN
(2023)
Trends in laboratory-confirmed bacterial meningitis (2012-2019): national observational study, England.
Lancet Reg Health Eur, 32.
p. 100692.
ISSN 2666-7762
https://doi.org/10.1016/j.lanepe.2023.100692
SGUL Authors: Ladhani, Shamez Nizarali
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Abstract
BACKGROUND: Bacterial meningitis is associated with significant morbidity and mortality worldwide. We aimed to describe the epidemiology, aetiology, trends over time and outcomes of laboratory-confirmed bacterial meningitis in England during 2012-2019. METHODS: UK Health Security Agency routinely receives electronic notifications of confirmed infections from National Health Service hospital laboratories in England. Data were extracted for positive bacterial cultures, PCR-positive results for Neisseria meningitidis or Streptococcus pneumoniae from cerebrospinal fluid and positive blood cultures in patients with clinical meningitis. FINDINGS: During 2012-19, there were 6554 laboratory-confirmed cases. Mean annual incidence was 1.49/100,000, which remained stable throughout the surveillance period (p = 0.745). There were 155 different bacterial species identified, including 68.4% (106/1550) Gram-negative and 31.6% (49/155) Gram-positive bacteria. After excluding coagulase-negative staphylococci (2481/6554, 37.9%), the main pathogens causing meningitis were Streptococcus pneumoniae (811/4073, 19.9%), Neisseria meningitidis (497/4073, 12.2%), Staphylococcus aureus (467/4073, 11.5%), Escherichia coli (314/4073, 7.7%) and group B streptococcus (268/4073, 6.6%). Pneumococcal meningitis incidence increased significantly during 2012-9, while meningococcal, group A streptococcal and tuberculous meningitis declined. Infants aged <3 months had the highest mean incidence (55.6/100,000; 95% CI, 47.7-63.5) driven mainly by group B streptococci, followed by 3-11 month-olds (8.1/100,000; 95% CI 7.1-9.0), where pneumococcal and meningitis predominated. The 30-day case-fatality rate (CFR) was 10.0% (71/6554). Group A streptococcal meningitis had the highest CFR (47/85, 55.3%). The probability of surviving at 30 days was 95.3% (95% CI, 93.4-97.3%) for infants and 80.0% for older adults (77-84%). INTERPRETATION: The incidence of bacterial meningitis has remained stable. The high CFR highlights a need for prevention through vaccination. FUNDING: PHE.
Item Type: | Article | ||||||||
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Additional Information: | Copyright Crown Copyright © 2023 Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). | ||||||||
Keywords: | Bacterial meningitis, Group B streptococci, Meningococcal meningitis, Pneumococcal meningitis, Surveillance, Bacterial meningitis, Group B streptococci, Meningococcal meningitis, Pneumococcal meningitis, Surveillance | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | ||||||||
Journal or Publication Title: | Lancet Reg Health Eur | ||||||||
ISSN: | 2666-7762 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution 4.0 | ||||||||
PubMed ID: | 37538400 | ||||||||
Web of Science ID: | WOS:001061723300001 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/115804 | ||||||||
Publisher's version: | https://doi.org/10.1016/j.lanepe.2023.100692 |
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