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.

Chacon-Cruz E1, Martinez-Longoria CA2, Llausas-Magana E3, Luevanos-Velazquez A4, Vazquez-Narvaez JA5, Beltran S6, Limon-Rojas AE7, Urtiz-Jeronimo F8, Castaneda-Narvaez JL9, Otero-Mendoza F9, Aguilar-Del Real F10, Rodriguez-Chagoyan J4, Rivas-Landeros RM11, Volker-Soberanes ML11, Hinojosa-Robles RM2, Arzate-Barbosa P9, Aviles-Benitez LK5, Elenes-Zamora FI3, Becka CM12, Ruttimann R13.

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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

PMID: 27551428 PMCID: PMC4976720 DOI: 10.1177/2051013616650158