Etiological and epidemiological features of acute meningitis or encephalitis in China: a nationwide active surveillance study.
cross_sectional · Level IV
Where this comes from
- Record sourced from PubMed, PMID 35036977.
- Also identified by DOI 10.1016/j.lanwpc.2021.100361 and PMC identifier 8743210.
- Licence recorded as CC BY-NC-ND.
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Abstract
Acute meningitis or encephalitis (AME) results from a neurological infection causing high case fatality and severe sequelae. AME lacked comprehensive surveillance in China. Nation-wide surveillance of all-age patients with AME syndromes was conducted in 144 sentinel hospitals of 29 provinces in China. Eleven AME-causative viral and bacterial pathogens were tested with multiple diagnostic methods. Between 2009 and 2018, 20,454 AME patients were recruited for tests. Based on 9,079 patients with all-four-virus tested, 28.43% (95% CI: 27.50%‒29.36%) of them had at least one virus-positive detection. Enterovirus was the most frequently determined virus in children <18 years, herpes simplex virus and Japanese encephalitis virus were the most frequently determined in 18-59 and ≥60 years age groups, respectively. Based on 6,802 patients with all-seven-bacteria tested, 4.43% (95% CI: 3.94%‒4.91%) had at least one bacteria-positive detection, <i>Streptococcus pneumoniae</i> and <i>Neisseria meningitidis</i> were the leading bacterium in children aged <5 years and 5-17 years, respectively. <i>Staphylococcus aureus</i> was the most frequently detected in adults aged 18-59 and ≥60 years. The pathogen spectrum also differed statistically significantly between northern and southern China. Joinpoint analysis revealed age-specific positive rates, with enterovirus, herpes simplex virus and mumps virus peaking at 3-6 years old, while Japanese encephalitis virus peaked in the ≥60 years old. As age increased, the positive rate for <i>Streptococcus pneumoniae</i> and <i>Escherichia coli</i> statistically significantly decreased, while for <i>Staphylococcus aureus</i> and <i>Streptococcus suis</i> it increased. The current findings allow enhanced identification of the predominant AME-related pathogen candidates for diagnosis in clinical practice and more targeted application of prevention and control measures in China, and a possible reassessment of vaccination strategy. China Mega-Project on Infectious Disease Prevention and the National Natural Science Funds.