Clinical And Epidemiological Analysis Of 154 Cases Of Epidemic Cerebrospinal Meningitis From 1983 To 2012

Objectives To understand the characteristics of epidemic cerebrospinal meningitis diagnosed by clinical and bacteriological in past 30 years in our hospital.Methods The clinical data of 154 cases from 1983 to 2012 were divided into two groups(Group A: 1983 to 2002, a total of 80 cases, group B: 2003 to 2012, a total of 74 cases) according to the epidemiological years and were retrospectively analyzed. The epidemiological data included age, gender, occupation, region, year distribution, month distribution and vaccination history, etc. Clinical features included clinical symptoms and signs, clinical classification, complications, peripheral blood, cerebrospinal fluid characteristics, etiology check, drug susceptibility results and clinical outcome. The statistical results of two groups of patients were compared with SPSS16.0 statistical software and t test and Chi square test were used for statistical analysis.Results The onset age of patients of group A were younger than group B, with 48.75%(39/80) cases under 5 years old in group A and 41.89%(31/74) cases from 16~20 years old in group B. Male patients were more than female(1.4:1), patients in rural areas were more than in urban(2.3:1) in two groups. The distribution of main occupation was at the elementary and middle school students, which accounted for 53.24%(82/154) in two groups. Most patients were onset in winter andspring,especially the 3~5 months(accounting for 68.18%) in two groups. The average age of the patients in the group B were older than group A(15.78:9.87), The cases of fulminant epidemic cerebrospinal meningitis in group B were more than group A(18.91%:7.50%), the incidence of conscious obstacle ratio was higher than in group A(43.24%:26.25), the number of days of hospitalization and neutrophil percentage value in blood were higher in group B than in group A respectively(13.50+5.09: 9.88+5.52, 85.62%: 78.64%, P<0.05),and proportion of petechia and ecchymosis occurred in the B group(63.51%) was lower than in the A group(88.75%). Patients in the group B had higher mortality than in A group(c2=0.21,p =0.904). The bacteria were not resistant to ceftriaxone and cefotaxime, and resistant rate to penicillin was 4.44% in two groups. But the bacteria resistant to sulfa drugs was 30.67% before 2003 and 100% after 2003.Conclusion 30 years epidemic cerebrospinal meningitis incidence was low status, not a pandemic. There were two small epidemic peak from 1983 to 2012, espectively from 1985 to 1986 and 2005. Patients in the B group were more serious than in group A. Patients of group B were with more mortality, complications and sequelae than group A. T Sulfa drug resistance rate was high, and the bacteria appeared resistant to penicillin phenomenon. There were not cephalosporin resistant cases. Penicillin combined ceftriaxone may be first selected.