J Bodilsen1, Merete Storgaard2, L Larsen3, L Wiese4, J Helweg-Larsen5, A-M Lebech6, C Brandt7, C Østergaard8, H Nielsen9. 1. Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark. Electronic address: Jacob.bodilsen@rn.dk. 2. Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark. 3. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark. 4. Department of Medicine, Section for Infectious Diseases, Sjællands University Hospital Roskilde, Roskilde, Denmark. 5. Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. 6. Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark. 7. Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital Hillerød, Hillerød, Denmark. 8. Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark. 9. Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
Abstract
OBJECTIVES: To monitor epidemiological trends of infectious meningitis (bacterial and viral) and encephalitis in Denmark. METHODS: Nationwide prospective observational study of all cases of proven community-acquired infectious meningitis and encephalitis in adults treated in all infectious diseases departments in Denmark from 1 January 2015 to 30 June 2016. We included data on symptoms, aetiology, treatment and outcome assessed by the Glasgow Outcome Scale (GOS) 30 days after discharge. GOS 1-4 was categorized as unfavourable outcome. RESULTS: During 18 months of observation, we identified 252 cases of viral meningitis (3.6/100 000/year), 214 cases of bacterial meningitis (3.1/100 000/year) and 96 cases of infectious encephalitis (1.4/100 000/year). In bacterial meningitis, Streptococcus pneumoniae was the most frequent infectious agent (n = 101) followed by Staphylococcus aureus (n = 24) and β-haemolytic streptococci (n = 14). Meningococcal meningitis was rare (n = 11). In encephalitis, herpes simplex virus type 1 was most common (n = 37) followed by varicella zoster virus (n = 20), whereas varicella zoster virus (n = 61) was most common in viral meningitis followed by enterovirus (n = 50) and herpes simplex virus type 2 (n = 46). Case fatality and unfavourable outcome occurred in 31/214 (15%) and 96/214 (45%) with bacterial meningitis and in 5/96 (5%) and 55/89 (62%) with encephalitis. For viral meningitis, unfavourable outcome occurred in 41/252 (17%). CONCLUSIONS: The epidemiology and clinical presentation of the examined central nervous system infections differed considerably and bacterial meningitis was more frequent than previously estimated. Overall prognosis remains poor for bacterial meningitis and encephalitis. Prospective nationwide clinical databases of central nervous system infections may be superior to epidemiological monitoring based on notifications or laboratory systems.
OBJECTIVES: To monitor epidemiological trends of infectious meningitis (bacterial and viral) and encephalitis in Denmark. METHODS: Nationwide prospective observational study of all cases of proven community-acquired infectious meningitis and encephalitis in adults treated in all infectious diseases departments in Denmark from 1 January 2015 to 30 June 2016. We included data on symptoms, aetiology, treatment and outcome assessed by the Glasgow Outcome Scale (GOS) 30 days after discharge. GOS 1-4 was categorized as unfavourable outcome. RESULTS: During 18 months of observation, we identified 252 cases of viral meningitis (3.6/100 000/year), 214 cases of bacterial meningitis (3.1/100 000/year) and 96 cases of infectious encephalitis (1.4/100 000/year). In bacterial meningitis, Streptococcus pneumoniae was the most frequent infectious agent (n = 101) followed by Staphylococcus aureus (n = 24) and β-haemolytic streptococci (n = 14). Meningococcal meningitis was rare (n = 11). In encephalitis, herpes simplex virus type 1 was most common (n = 37) followed by varicella zoster virus (n = 20), whereas varicella zoster virus (n = 61) was most common in viral meningitis followed by enterovirus (n = 50) and herpes simplex virus type 2 (n = 46). Case fatality and unfavourable outcome occurred in 31/214 (15%) and 96/214 (45%) with bacterial meningitis and in 5/96 (5%) and 55/89 (62%) with encephalitis. For viral meningitis, unfavourable outcome occurred in 41/252 (17%). CONCLUSIONS: The epidemiology and clinical presentation of the examined central nervous system infections differed considerably and bacterial meningitis was more frequent than previously estimated. Overall prognosis remains poor for bacterial meningitis and encephalitis. Prospective nationwide clinical databases of central nervous system infections may be superior to epidemiological monitoring based on notifications or laboratory systems.
Authors: Ann-Brit E Hansen; Hanne T Vestergaard; Ram B Dessau; Jacob Bodilsen; Nanna S Andersen; Lars H Omland; Claus B Christiansen; Svend Ellermann-Eriksen; Lene Nielsen; Thomas Benfield; Henrik T Sørensen; Christian Ø Andersen; Anne-Mette Lebech; Niels Obel Journal: Clin Epidemiol Date: 2020-07-16 Impact factor: 4.790
Authors: Tolga Dittrich; Stephan Marsch; Adrian Egli; Stephan Rüegg; Gian Marco De Marchis; Sarah Tschudin-Sutter; Raoul Sutter Journal: BMC Infect Dis Date: 2020-04-23 Impact factor: 3.090