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Ther Adv Vaccines. 2016 Jan;4(1-2):15-9. doi: 10.1177/2051013616650158. Epub 2016 Jan 1.

Neisseria meningitidis and Streptococcus pneumoniae as leading causes of pediatric bacterial meningitis in nine Mexican hospitals following 3 years of active surveillance.

Author information

1
Hospital General de Tijuana, Paseo Centario S/N, Zona del Rio, Tijuana, 22010, Mexico.
2
Hospital Universitario 'Dr. Jose Eleuterio Gonzalez,' Monterrey, Nuevo Leon, Mexico.
3
Hospital Pediatrico de Sinaloa 'Dr. Rigoberto Aguilar Pico,' Culiacan, Sinaloa, Culiacan, Mexico.
4
Hospital Civil de Guadalajara 'Fray Antonio Alcalde,' Guadalajara, Jalisco, Guadalajara, Mexico.
5
Hospital Infantil de Morelia 'Eva Samano de Lopez Mateos,' Morelia, Michoacan, Morelia, Mexico.
6
Hospital General 'Dr. Rafael Pascacio Gamboa,' Tuxtla Gutierrez Chiapas, Tuxtla Gutierrez, Mexico.
7
Hospital de Pemex Picacho, Mexico City, Mexico City, Mexico.
8
Hospital para el Niño de Toluca, Edo. Mexico, Toluca, Mexico.
9
Instituto Nacional de Pediatria, Mexico City, Mexico.
10
Hospital Médica Sur, Mexico City, Mexico.
11
Hospital General de Tijuana, Tijuana, Mexico.
12
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, New Orleans, LA, USA.
13
FIDEC, University of Miami, Miami, FL, USA.

Abstract

OBJECTIVES:

Meningococcal meningitis is reported as a rare condition in Mexico. There are no internationally published studies on bacterial causes of meningitis in the country based on active surveillance. This study focuses on finding the etiology of bacterial meningitis in children from nine Mexican Hospitals.

METHODS:

From January 2010 to February 2013, we conducted a three years of active surveillance for meningitis in nine hospitals throughout Mexico. Active surveillance started at the emergency department for every suspected case, and microbiological studies confirmed/ruled out all potentially bacterial pathogens. We diagnosed based on routine cultures from blood and cerebrospinal fluid (not polymerase chain reaction or other molecular diagnostic tests), and both pneumococcal serotyping and meningococcal serogrouping by using standard methods.

RESULTS:

Neisseria meningitidis was the leading cause, although 75% of cases occurred in the northwest of the country in Tijuana on the US border. Serogroup C was predominant. Streptococcus pneumoniae followed Neisseria meningitides, but was uniformly distributed throughout the country. Serotype 19A was the most incident but before universal implementation of the 13-valent pneumococcal conjugate vaccine. Other bacteria were much less common, including Enterobacteriaceae and Streptococcus agalactiae (these two affecting mostly young infants).

CONCLUSIONS:

Meningococcal meningitis is endemic in Tijuana, Mexico, and vaccination should be seriously considered in that region. Continuous universal vaccination with the 13-valent pneumococcal conjugate vaccine should be nationally performed, and polymerase chain reaction should be included for bacterial detection in all cultures - negative but presumably bacterial meningitis cases.

KEYWORDS:

active surveillance; bacterial meningitis; children; meningococcal meningitis; pneumococcal meningitis

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