Incidence of bacterial meningitis (2001–2005) in Lazio, Italy: the results of a integrated surveillance system

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Monitoring the incidence of bacterial meningitis is important to plan and evaluate preventive polices. The study's aim was to estimate the incidence of bacterial meningitis by aetiological agent in the period 2001–2005, in Lazio Italy (5.3 mln inhabitants).

Methods

Data collected from four sources – hospital surveillance of bacterial meningitis, laboratory information system, the mandatory infectious diseases notifications, and hospital information system – were combined into a single archive.

Results

944 cases were reported, 89% were classified as community acquired. S. pneumoniae was the most frequent aetiological agent in Lazio, followed by N. meningitis. Incidence of H. influenzae decreased during the period. 17% of the cases had an unknown aetiology and 13% unspecified bacteria. The overall incidence was 3.7/100,000. Children under 1 year were most affected (50.3/100.000), followed by 1–4 year olds (12.5/100,000). The percentage of meningitis due to aetiological agents included in the vaccine targets, not considering age, is 31%. Streptococcus spp. was the primary cause of meningitis in the first three months of life. The capture-recapture model estimated underreporting at 17.2% of the overall incidence.

Conclusion

Vaccine policies should be planned and monitored based on these results. The integrated surveillance system allowed us to observe a drop in H. influenzae b meningitis incidence consequent to the implementation of a mass vaccination of newborns.

Related collections

Most cited references 33

Record: found
Abstract: found
Article: not found

Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC.

Stephanie J. Schrag, Rachel Gorwitz, Kristi Fultz-Butts … (2002)

Group B streptococcus (GBS) remains a leading cause of serious neonatal infection despite great progress in perinatal GBS disease prevention in the 1990s. In 1996, CDC, in collaboration with other agencies, published guidelines for the prevention of perinatal group B streptococcal disease (CDC. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR 1996;45[RR-7]:1-24). Data collected after the issuance of the 1996 guidelines prompted reevaluation of prevention strategies at a meeting of clinical and public health representatives in November 2001. This report replaces CDC's 1996 guidelines. The recommendations are based on available evidence and expert opinion where sufficient evidence was lacking. Although many of the recommendations in the 2002 guidelines are the same as those in 1996, they include some key changes: * Recommendation of universal prenatal screening for vaginal and rectal GBS colonization of all pregnant women at 35-37 weeks' gestation, based on recent documentation in a large retrospective cohort study of a strong protective effect of this culture-based screening strategy relative to the risk-based strategy * Updated prophylaxis regimens for women with penicillin allergy * Detailed instruction on prenatal specimen collection and expanded methods of GBS culture processing, including instructions on antimicrobial susceptibility testing * Recommendation against routine intrapartum antibiotic prophylaxis for GBS-colonized women undergoing planned cesarean deliveries who have not begun labor or had rupture of membranes * A suggested algorithm for management of patients with threatened preterm delivery * An updated algorithm for management of newborns exposed to intrapartum antibiotic prophylaxis Although universal screening for GBS colonization is anticipated to result in further reductions in the burden of GBS disease, the need to monitor for potential adverse consequences of intrapartum antibiotic use, such as emergence of bacterial antimicrobial resistance or increased incidence or severity of non-GBS neonatal pathogens, continues, and intrapartum antibiotics are still viewed as an interim strategy until GBS vaccines achieve licensure.

0 comments Cited 126 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Bacterial meningitis in the United States in 1995. Active Surveillance Team.

Anne Schuchat, Katherine Robinson, Jay Wenger … (1997)

Before the introduction of the conjugate vaccines, Haemophilus influenzae type b was the major cause of bacterial meningitis in the United States, and meningitis was primarily a disease of infants and young children. We describe the epidemiologic features of bacterial meningitis five years after the H. influenzae type b conjugate vaccines were licensed for routine immunization of infants. Data were collected from active, population-based surveillance for culture-confirmed meningitis and other invasive bacterial disease during 1995 in laboratories serving all the acute care hospitals in 22 counties of four states (total population, more than 10 million). The rates were compared with those for 1986 obtained by similar surveillance. On the basis of 248 cases of bacterial meningitis in the 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 B streptococcus was the predominant pathogen among newborns, N. meningitidis among children 2 to 18 years old, and S. pneumoniae among adults. Pneumococcal meningitis had the highest case fatality rate (21 percent) and in 36 percent of cases was caused by organisms that were not susceptible to penicillin. From these data, we estimate that 5755 cases of bacterial meningitis were caused by these five pathogens in the United States in 1995, as compared with 12,920 cases in 1986, a reduction of 55 percent. The median age of persons with bacterial meningitis increased greatly, from 15 months in 1986 to 25 years in 1995, largely as a result of a 94 percent reduction in the number of cases of H. influenzae meningitis. Because of the vaccine-related decline in meningitis due to H. influenzae type b, bacterial meningitis in the United States is now a disease predominantly of adults rather than of infants and young children.

0 comments Cited 123 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Capture-recapture and multiple-record systems estimation I: History and theoretical development. International Working Group for Disease Monitoring and Forecasting.

International Working Group for Disease Monitoring and Forecasting (1995)

This paper reviews the historical background and the theoretical development of models for the analysis of data from capture-recapture or multiple-record systems for estimating the size of closed populations. The models and methods were originally developed for use in fisheries and wildlife biology and were later adapted for use in connection with human populations. Application to epidemiology came much later. The simplest capture-recapture model involves two lists or samples and has four key assumptions: that the population is closed, that individuals can be matched from capture to recapture, that capture in the second sample is independent of capture in the first sample, and that the capture probabilities are homogeneous across all individuals in the population. Log-linear models provide a convenient representation for this basic capture-recapture model and its extensions to K lists. The paper provides an overview for these models and illustrates how they allow for dependency among the lists and heterogeneity in the population. The use of log-linear models for estimation in the presence of both dependence and heterogeneity is illustrated on a four-list example involving ascertainment of diabetes using data gathered in 1988 from residents of Casale Monferrato, Italy. The final section of the paper discusses techniques for model selection in the context of models for estimating the size of populations.

0 comments Cited 37 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): BMC Infect Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central

ISSN (Electronic): 1471-2334

Publication date Collection: 2009

Publication date (Electronic): 5 February 2009

Volume: 9

Page: 13

Affiliations

[1 ]Agency for Public Health, Lazio Region, Rome, Italy

[2 ]Dipartimento di Economia Finanza e Statistica, University of Perugia, Perugia, Italy

Article

Publisher ID: 1471-2334-9-13

DOI: 10.1186/1471-2334-9-13

PMC ID: 2645407

PubMed ID: 19196453

SO-VID: 5900d912-2564-4204-b149-29e91c2735ab

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Incidence of bacterial meningitis (2001–2005) in Lazio, Italy: the results of a integrated surveillance system

Read this article at

Abstract

Background

Methods

Results

Conclusion

Related collections

Bacterial extracellular vesicles

Most cited references 33

Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC.

Bacterial meningitis in the United States in 1995. Active Surveillance Team.

Capture-recapture and multiple-record systems estimation I: History and theoretical development. International Working Group for Disease Monitoring and Forecasting.

Author and article information

Journal

Affiliations

Article

History

Categories

Comments

Comment on this article

Similar content 23

Cited by 16

Most referenced authors 296