All issues > Volume 51(10); 2008

Original Article

Korean J Pediatr. 2008;51(10):1077-1084. Published online October 15, 2008.

Bacterial meningitis in children experienced at a university hospital, 1993-2006

Sung Yoon SY Cho¹, Tae Yeon TY Kim¹, Hyunju HJ Lee¹, Kyung Hyo KH Kim¹, Eun Sun ES Yoo¹, Hae Soon HS Kim¹, Eun Ae EA Park¹, Kyung Ha KH Ryu¹, Jeong Wan JW Seo¹, Sejung SJ Sohn¹, Seung Joo SJ Lee¹

¹Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea

Correspondence Kyung Hyo KH Kim ,Email: kaykim@ewha.ac.kr

Abstract

Purpose
: Despite the seriousness of bacterial meningitis in children, there is little information on the incidence, causative organisms, mortality rate and age distribution. We studied the frequency by age group and causal pathogens, and clinical characteristics in children with bacterial meningitis in the private sector in Korea.
Methods
: The medical records containing the data on bacterial meningitis patients under 18 years of age confirmed by cerebrospinal fluid (CSF) findings were retrospectively analyzed from September, 1993 to August, 2006 at Ewha Womans University Mokdong Hospital.
Results
: Eighty-one cases of bacterial meningitis were observed. Overall the most common organism was Streptococcus agalactiae (group B streptococcus, GBS) (30 cases, 37.0%) followed by Haemophilus influenzae (22 cases, 27.2%), Streptococcus pneumoniae (12 cases, 14.8%), Escherichia coli (3 cases, 3.7%), Neisseria meningitidis (1 case, 1.2%) and others (13 cases, 16.0%). In neonates and young infants under 2 months, the most common organism was GBS. In children between 3 months, and 5 years, the most common organism was H. influenzae. S. pneumoniae was the most common organism in children over 5 years of age. Thirty-one patients (38.3%) had complications. Of all ages, the mortality rate of bacterial meningitis markedly decreased compared with the previously reported rate.
Conclusion
: In neonates, GBS meningitis was most common. The frequency of H. influenzae meningitis decreased after the introduction of H. influenzae type b vaccination. A strategy for the prevention of GBS meningitis in neonates should be established. The influence of the pneumococcal conjugate vaccine on S. pneumoniae meningitis should be studied.

Keywords :Bacterial meningitis, Streptococcus agalactiae, Haemophilus influenzae, Streptococcus pneumoniae