[Incidence of bacterial meningitis in the Netherlands; comparison of 3 registration systems, 1977-1982].
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Biomedical subjects
Publications and source records attributed to P Bol.
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Data on the incidence of bacterial meningitis (BM) in the Netherlands are important for a cost-benefit analysis of new effective vaccines. During the period 1977-1982 we compared the notifications of meningococcal meningitis, diagnoses on discharge from hospital of all causes of BM (Stichting Medische Registratie, Medical Registration Foundation; SMR) and bacteriological data (Netherlands Reference Laboratory for Bacterial Meningitis; RBM). Notifications of meningococcal meningitis were 42% lower than SMR-data. RBM-registration of meningococcal, haemophilus and pneumococcal meningitis was 20% lower than SMR. Reviewing patient-records we found that these diseases had not been reported in 16% (RBM) and 11% (SMR) of cases. We estimate the incidence of BM during an endemic period at 8.0 per 100 000 population per year, to which the meningococcus contributes 20-25%. In children under 5 years of age the age-specific incidence of haemophilus meningitis is 22/100 000.
One hundred and twenty-six clinical isolates of Escherichia coli from the CSF of neonates, obtained in the Netherlands during 1976 to 1982, were tested for sensitivity to five antibiotics. The usefulness of the generally recommended initial therapy, a combination of ampicillin and gentamicin, is supported in the majority of cases. On the basis of the in-vitro results, cefotaxime would have been effective as a therapy for all cases. Ampicillin and cefuroxime resistance occurred mostly in neonates who had received antibiotics prophylactically, neonates whose mothers had fever during labour or in neonates who had been nursed in incubators for more than one week.
64 clinical isolates of group B streptococci from cerebrospinal fluids of neonates were tested for susceptibility to 6 antibiotics. The strains were obtained in The Netherlands during 7 years. The usefulness of the generally recommended initial therapy, a combination of ampicillin and gentamicin, is supported.
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