Trend of bacterial meningitis in children over a 14 year period (1981 through 1994) in Japan--an analysis based on studies in 27 institutions

Y. Kobayashi, K. Sunakawa, K. Fujita, M. Saijo, K. Murono, H. Sakata, S. Maruyama, F. Inyaku, Y. Toyonaga, S. Iwata, H. Meguro, I. Terashima, N. Ishikawa, N. Oshima, S. Uehara, A. Nakamura, T. Kurosaki, N. Kamoshita, S. Ohkawa, M. ShimizuA. Ozaki, K. Fukuoka, H. Akita, T. Yokota, R. Fujii

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Abstract

We observed 266 children with purulent meningitis in 27 institutions in Japan during the 14 years from 1981 on dividing these years into 3 periods, 1981-1985, 1986-1990 and 1991-1994, and studied the trend of causative organisms identified in 254 among the 266 patients. Their ages were less than 3 months after birth in 50 children and 3 months or older in 216: there were 141 boys and 125 girls. The causative organisms were H. influenzae in 134 patients and S. pneumoniae in 50, most of them being aged 3 months or older. Next to the above bacteria ranked S. agalactiae in 29 and E. coli in 12, many of the patients were aged less than 3 months. Staphylococcus spp. was found in 7 patients and about 70% of them were aged 3 months or older. L. monocytogenes was found in 4 patients and N. meningitidis in 3 and they were aged 3 months or older in both patient groups. S. pyogenes, Enterococcus spp., Peptostreptococcus spp., P. Mirabilis and Enterobacter spp. were detected each in 1 patient. The causative organism was unknown in 21 patients and there was no double infection. H. influenzae were detected in 18 patients in 1981-1985 period (36.7%), in 56 in 1986-1990 (54.9%) and in 60 in 1991-1994 (63.8%) showing an increasing tendency, but S. pneumoniae exhibited neither an increasing nor decreasing tendency. There was a decreasing tendency with S. agalactiae and E. coli, but the details were not clear because there were few patients aged less than 3 months. Although the period of coexistence of 4 main bacterial species was not made clear in this study. Listeria is considered to develop mainly in the early childhood, and we believe that the conventional way of using a cephem preparation and ampicillin combined for patients under 6 years need not be altered. However, panipenem (phonetic) is likely to be effective for insensible S. pneumoniae for the time being.

Original languageEnglish
Pages (from-to)1017-1024
Number of pages8
JournalKansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases
Volume71
Issue number10
DOIs
Publication statusPublished - 1997 Oct

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ASJC Scopus subject areas

  • Medicine(all)

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Kobayashi, Y., Sunakawa, K., Fujita, K., Saijo, M., Murono, K., Sakata, H., Maruyama, S., Inyaku, F., Toyonaga, Y., Iwata, S., Meguro, H., Terashima, I., Ishikawa, N., Oshima, N., Uehara, S., Nakamura, A., Kurosaki, T., Kamoshita, N., Ohkawa, S., ... Fujii, R. (1997). Trend of bacterial meningitis in children over a 14 year period (1981 through 1994) in Japan--an analysis based on studies in 27 institutions. Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 71(10), 1017-1024. https://doi.org/10.11150/kansenshogakuzasshi1970.71.1017