Following recommendations for the use of adjunctive dexamethasone for pneumococcal meningitis, the introduction of two preventative vaccines and a complementary treatment has resulted in a significant decrease in incidence and mortality of bacterial meningitis. This is the conclusion of experts at the University of Texas Health Science Center at Houston, who published their study in the journal The Lancet Infectious Diseases, entitled, “Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study.”
Although bacterial meningitis is known to lead to a high level of mortality for those who contract it, there is still little data to support trends that exist in the U.S. epidemiologically after the recommended adjunctive use of the corticosteroid dexamethasone. As a result, the researchers involved in the study sought to expand the understanding of how the patterns and causes of bacterial infection have changed throughout the country from the use of conjugate vaccinations for infections such as bacterial meningitis, specifically investigating the mortality rate as it pertains to the use of adjunctive dexamethasone as a treatment.
The UTHealth team used the HealthCare Cost Utilization Project (HCUP) network database, which included over 50,000 people treated for bacterial meningitis, in order to cross-reference the records of hospital discharges in the United States between 1997 and 2010 that were specific to both nosocomial and community bacterial meningitis incidences, as well as the rate of inpatient mortality associated with the infection.
This was the first time a study analyzed both community-acquired bacterial meningitis and healthcare-associated bacterial meningitis in the U.S., according to Rodrigo Hasbun, senior author and associate professor in the Division of Infectious Diseases at the UTHealth Medical School, in a recent UTHealth press release.
Results showed that incidences of streptococcus pneumonia decreased from a 1997 rate of 0.8 per 100,000 people, to just 0.3 per 100,000 people registered by the end of 2010. Additionally, pneumococcal meningitis mortality rates were also observed to have fallen in the two periods of 2005-2008 and 2002-2004. Finally, diagnoses of Neisseria meningitides infections also markedly decreased, with rates falling from 0.721 per 100,000 patients in 1997, to only 0.123 per 100,000 patients in 2010. The researchers particularly noted that the decreasing bacterial data sets for Neisseria meningitides have demonstrated that this pathogen is in fact “close to common bacterial causes of nosocomial meningitis such as staphylococcus and Gram-negative bacteria and to Haemophilus influenza,” as quoted in the The Lancet Infectious Diseases abstract.
These findings led researchers to conclude that, although streptococcus pneumonia has been found to be the predominant cause of bacterial meningitis cases in the United States, conjugated vaccines are indeed playing a major role in significantly reducing both the incidences of the infection, as well as the mortality rate. As a result, researchers assert that the recommended prescription of adjunctive dexamethasone therapy for pneumococcal meningitis can in turn be associated with the encouraging results of the observational study.