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

Korean Journal of Pediatrics 2008;51(10):1077-1084.
Published online October 15, 2008.
Bacterial meningitis in children experienced at a university hospital, 1993-2006
Sung Yoon Cho, Tae Yeon Kim, Hyunju Lee, Kyung Hyo Kim, Eun Sun Yoo, Hae Soon Kim, Eun Ae Park, Kyung Ha Ryu, Jeong Wan Seo, Sejung Sohn, Seung Joo Lee
Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
서울의 한 대학병원에서 경험한 소아의 세균성 수막염: 1993-2006
조성윤, 김태연, 이현주, 김경효, 유은선, 김혜순, 박은애, 유경하, 손세정, 서정완, 이승주
이화여자대학교 의학전문대학원 소아과학교실
Correspondence: 
Kyung Hyo 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.
Key Words: Bacterial meningitis, Streptococcus agalactiae, Haemophilus influenzae, Streptococcus pneumoniae


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