Dokkyo Journal of Medical Sciences
44（2）：169 〜 171，2017
44（2）（2017）

Bacterial meningitis in childhood

169

Short Communication

Bacteriological Study of 53 Children with Bacterial
Meningitis in our Hospital（2000-2017）
Shinichiro Ariga 1 , George Imataka 1 , Atsushi Yoshida 2 ,Hidemitsu Kurosawa 2 , Shigemi Yoshihara 1
12Department of Pediatrics, Dokkyo Medical University

Department of Infectious Diseases, Tokyo Women’s Medical University

Key Words：Streptoccocus pneumoniae, Hemophilus influenza, Group B Streptococcus

INTRODUCTION

vaccines both HiB and PCV in our Hospital.

MATERIAL and METHODSClinically, bacterial meningitis should be mostAttentive in childhood infections. The mortality rate

In this survey, children under the age of 16 whoof bacterial meningitis in children has decreased withwere admitted to Dokkyo Medical University Hospital

advancments in antibiotics. However, meningitis ofin Tochigi prefecture were examined. The researchchildren with neurological sequelae still remains. As aperiod spanned from January 2000 to March 2017 forresult, vaccination against causal bacteria of childhood

17 years and 3 months. For the method of research, ameningitis was promoted worldwide mainly by World

patient database of the bacteria laboratory of Dokkyo

Health Organization. In Japan, Hemophilus influenza

Medical University Hospital was used.

type B（Hib）vaccine was introduced in December

We retrospectively analyzed cases in which caus-

2008, 7-valent pneumococcal conjugate vaccine（PCV

ative bacteria were detected from the result of bacte-7）in February 2010 was introduced by arbitrary vac-

rial culture from cerebral spinal fluid. In our study,cination. In 2013, HiB vaccine became regular vaccina-

we examined cases of causal bacteria from the resultstion. In addition, PCV 7 was changed to 13-valentof cerebrospinal fluid cultures, checked pediatric inpa-pneumococcal conjugate vaccine（PCV 13）.

tients list, and finally diagnosed bacterial meningitis in

In recent years, there have been several reports

childhood.

from domestic and foreign countries with reduced

Based on the results of this study, we examined 1）

meningitis and bacteremia in children after the intro-

type and number of causal bacteria and 2）yearly

duction of Hib and PCV vaccines. Therefore wetrends of childhood meningitis caused by each causal

report on the trends of children’s meningitis in thebacteria.

periods before and after the introduction of these twoRESULT
1）Type and number of causal bacteria
During the study period, total of 53 children were

Received March 13, 2017；accepted April 11, 2017
Reprint requests to：George Imataka

reported with cases of bacterial meningitis. Of thecausal bacteria, Streptococcus pneumoniae was the880 Kitakobayashi, Mibu, Shimotsuga, Tochigi

most prominent with 20 cases, Hemophilus influenza

321-0293 Japan.

in 16 cases, Group B Streptococcus in 16 cases, and170

Shinichiro Ariga

DJMS

Figure 1 A nnual trend of childhood bacterial meningitis by causal bacteria in our hospital.
（Blue：Streptoccocus pneumoniae, Red：Hemophilus influenza, Green：Group B
Streptococcus, Purple：Listeria）

2010, it is recognized that the reduction of meningitis

Listeria in 1 case.

caused by Streptococcus pneumoniae and the disap2）Yearly trends of childhood meningitis caused bypearance of meningitis caused by Hemophilus influen-each causal bacteria

za. In addition, after 2010, meningitis caused by Group

Pediatric case of meningitis with Streptococcus pneu-

B Streptococcus was the biggest problem for meningi-moniae was recognized from 2 0 0 0 to 2 0 1 5 . In thetis developing in children. Our results indicate thattrend of meningitis due to Streptococcus pneumoniae,

the preventive effect of the two vaccines with HiB

the number of cases decreased since 2010. Childhoodand PCV for pediatric bacterial meningitis, which wasmeningitis with Hemophilus influenza was observed

introduced in 2008 and 2010 at our university hospi-

from 2000 to 2010, but there were no onset and hos-tal. Shinjo M et al. reported recent trend in pediatricpitalization since 2011. Group B Streptococcus was rec-bacterial meningitis in Japan after the introduction ofognized throughout almost the entire investigationsuch two vaccines 1） and our results have supported

period from 2000 to 2017.

the survey in spite of the number of cases being so

Case of pediatric meningits by Streptococcus pneu-few.

moniae and Hemophilus influenza had decreased pastMoreover, this result can be said that the two vac-2009 and 2010 respectively. On the other hand, sincecines changed to childhood meningitis as regional

2011 Group B Streptococcus has become a major caus-

pediatric medical environment. Ishiwada N et al.

al bacteria for pediatric meningitis（Figure 1）. In ourreported the incidence survey of pediatric invasive

hospital, there was no hospitalization of meningitis

meningitis in Chiba prefecture 2）. We estimated thecaused by Neisseria and Escherichia. coli which are

results of long periods of this research at a single uni-

common in newborns and infants.

versity hospital at a fixed point in Tochigi prefecture

DISCUSSIONAs I mentioned in the introduction, the results onbrings a great interest in preventive medicine for concern with public health in pediatric onset bacterialmeningitis.

the annual trend of childhood onset meningitis in our

One out of 4 to 5 pregnant woman has Group B

hospital, which we investigated, the type of bacteria

Streptococcus in the vagina and rectum. One in 100-causing it has changed around 2010. That is, around

250 of children born from a mother carrying Group B

44（2）（2017）

Bacterial meningitis in childhood

Streptococcus suffers from an infection associated withthis pathogen.
As a countermeasure, by treating with penicillin or
ampicillin to the mother at the time of delivery, mostof the neonatal Group B Streptococcus infection can beprevented.
However, complete prevention for pregnant women
to neonatal infection is difficult.
Edomond et al. has investigated meningitis due to171

Acknowledgement.

We appreciate department ofpediatrics and all technical staff at the clinical laboratory center at Dokkyo Medical University Hospital.
REFERENCES1）Shinjo M, Iwata S, Yagihashi T, et al：Recent trends
in pediatric bacterial meningitis in Japan - a country
where Haemophilus influenza type b and Streptococcus pneumoniae conjugated vaccines have just been

neonatal Group B Streptococcus. Causative types ofintroduced. J Infec Chemother 20：477-483, 2014.

Group B Streptococcus are type III（48.9％）, type Ia2）Ishiwada N, Hishiki H, Nagasawa K et al：The inci-（22.9％）, type V（9.1％）, type Ib（7.0％）, type II（6.2

dence of pediatric invasive Haemophilus influza and％）and insists the need to develop a new vaccine forpneumococcal disease in Chiba prefecture, Japan

Group B Streptococcus for the mothers. But in fact, it

before and after the introduction of conjugate vac-

will take long time to develop a new Group B Strepto-cines. Vaccine 32：5425-5431, 2014.

coccus vaccine. We need to recognize the importance3）Edmond KM, Kortsalioudaki C, Scott S, et al. Groupof Group B Streptococcus as an old and new causal

B Streptoccocal disease in infants aged younger thanbacterium in the childhood onset of bacterial meningi-

e months：systematic review and meta-analysis.

tis.

Lancet 379：547-556, 2012.