Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in context
Summary: 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 ro...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | The Lancet Regional Health. Europe |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666776223001114 |
| _version_ | 1827893214539939840 |
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| author | Sathyavani Subbarao Sonia Ribeiro Helen Campbell Ifeanyichukwu Okike Mary E. Ramsay Shamez N. Ladhani |
| author_facet | Sathyavani Subbarao Sonia Ribeiro Helen Campbell Ifeanyichukwu Okike Mary E. Ramsay Shamez N. Ladhani |
| author_sort | Sathyavani Subbarao |
| collection | DOAJ |
| description | Summary: 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. |
| first_indexed | 2024-03-12T21:50:38Z |
| format | Article |
| id | doaj.art-db625c53a7014f8abb0598b8eadd6b4a |
| institution | Directory Open Access Journal |
| issn | 2666-7762 |
| language | English |
| last_indexed | 2024-03-12T21:50:38Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj.art-db625c53a7014f8abb0598b8eadd6b4a2023-07-26T04:09:42ZengElsevierThe Lancet Regional Health. Europe2666-77622023-09-0132100692Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in contextSathyavani Subbarao0Sonia Ribeiro1Helen Campbell2Ifeanyichukwu Okike3Mary E. Ramsay4Shamez N. Ladhani5Immunisation and Countermeasures Division, UK Health Security Agency, London, UK; Department of Infectious Diseases, St George's Hospital, University of London, London, UKImmunisation and Countermeasures Division, UK Health Security Agency, London, UKImmunisation and Countermeasures Division, UK Health Security Agency, London, UKDepartment of Paediatrics, Derby Children's Hospital, UKImmunisation and Countermeasures Division, UK Health Security Agency, London, UKImmunisation and Countermeasures Division, UK Health Security Agency, London, UK; Paediatric Infectious Diseases Research Group (PIDRG), St George's University of London, London, UKSummary: 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.http://www.sciencedirect.com/science/article/pii/S2666776223001114Bacterial meningitisGroup B streptococciMeningococcal meningitisPneumococcal meningitisSurveillance |
| spellingShingle | Sathyavani Subbarao Sonia Ribeiro Helen Campbell Ifeanyichukwu Okike Mary E. Ramsay Shamez N. Ladhani Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in context The Lancet Regional Health. Europe Bacterial meningitis Group B streptococci Meningococcal meningitis Pneumococcal meningitis Surveillance |
| title | Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in context |
| title_full | Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in context |
| title_fullStr | Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in context |
| title_full_unstemmed | Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in context |
| title_short | Trends in laboratory-confirmed bacterial meningitis (2012–2019): national observational study, EnglandResearch in context |
| title_sort | trends in laboratory confirmed bacterial meningitis 2012 2019 national observational study englandresearch in context |
| topic | Bacterial meningitis Group B streptococci Meningococcal meningitis Pneumococcal meningitis Surveillance |
| url | http://www.sciencedirect.com/science/article/pii/S2666776223001114 |
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