INCIDENCE AND ETIOLOGY OF PURULENT MENINGITIS IN CHILDREN BEFORE AND AFTER THE INTRODUCTION OF HAEMOPHILUS INFLUENZAE VACCINE

Cilj rada: utvrditi broj i etiologiju gnojnih meningitisa u razdoblju od 1999.-2013. te prikupiti i usporediti podatke o kliničkoj slici i komplikacijama gnojnih meningitisa djece u dobi 0-5 godina starosti u razdoblju prije i nakon uvođenja Hib cjepiva u redovni kalendar cijepljenja. Materijali i metode: Retrospektivno su prikupljeni podatci o gnojnim meningitisima u djece starosti 0-5 godina koja su liječena na Klinici za infektivne bolesti Kliničkog bolničkog centra Split u razdoblju od 1999.-2013. godine. Uključena su djeca s pozitivnim nalazom kulture cerebrospinalnog likvora i/ili hemokulture, ali i ona s neutvrđenom etiologijim meningitisa koja su imala citološki i biokemijski nalaz cerebrospinalnog likvora sukladan gnojnom meningitisu. Uspoređeni su podatci dobiveni u razdoblju prije i nakon uvođenja obaveznog cijepljenja protiv H. influenzae tip b 2002. godine. Statistička obrada podataka učinjena je pomoću χ²-testa. Rezultati: Dokazan je značajan pad pojavnosti gnojnih meningitisa uzrokovanih H. influenzae već tijekom prvih 5 godina obaveznog cijepljenja. U razdoblju nakon toga gnojni meningitisi uzrokovani H. influenzae praktično se više ne pojavljuju. U promatranom razdoblju također je značajno opao i broj gnojnih meningitisa čija je dijagnoza postavljena nakon 24 sata od početka simptoma te se smanjio broj komplikacija uzrokovanih gnojnim meningitisom. Zaključak: uvođenje Hib cjepiva dovelo je do drastičnog pada pojavnosti gnojnih meningitisa uzrokovanih Haemophilusom influenzae tib b. U promatranom razdoblju došlo je do značajnog smanjenja broja gnojnih meningitisa čija je dijagnoza postavljena nakon 24 sata od početka simptoma te se smanjio i broj komplikacija uzrokovanih gnojnim meningitisom.Objective: To determine the number and etiology of purulent meningitis in the period from 1999-2013 and collect and compare data on the clinical presentation and complications of purulent meningitis in children from 0-5 years of age in the period before and after the introduction of Hib vaccine in the obligatory vaccination schedule. Materials and Methods: Data on purulent meningitis in children aged 0-5 years who were treated at the Clinic for Infectious Diseases, University Hospital Split in period from 1999-2013 was collected retrospectively. Children with positive culture of cerebrospinal fluid and / or blood culture were included. Study also included children with undetermined etiology of meningitis that had cytological and biochemical findings of cerebrospinal fluid consistent with purulent meningitis. The data collected were compared in the period before and after the introduction of mandatory vaccination against H. influenzae type b in 2002. Statistical analysis was performed using χ²-test. Results: A significant decrease in the incidence of purulent meningitis caused by H. influenzae was proven during the first five years of compulsory vaccination. In last 6 years purulent meningitis caused by H. influenzae practically no longer appeared. During the study period significant decrease in the number of purulent meningitis, which was diagnosed 24 hours after onset of symptoms was shown, as well as the reduction of the number of complications caused by purulent meningitis. Conclusion: The introduction of Hib vaccine has led to a drastic decline in the incidence of purulent meningitis caused by Haemophilus influenzae type b. During this period there was a significant reduction in the number of purulent meningitis which was diagnosed 24 hours after the onset of symptoms and reduction of the number of complications caused by purulent meningitis