Epidemiology of invasive meningococcal disease in 13 government hospitals in Thailand, 1994-1999
Pancharoen, C.; Hongsiriwon, S.; Swasdichai, K.; Puthanakit, T.; Tangsathapornpong, A.; Lolekha, S.; Punpanich, W.; Tarunotai, U.; Warachit, B.; Mekmullica, J.; Kosalaraksa, P.; Chokephaibulkit, K.; Kerdpanich, A.
Southeast Asian Journal of Tropical Medicine and Public Health 31(4): 708-711
2000
ISSN/ISBN: 0125-1562 PMID: 11414417 Document Number: 524495
This study was conducted to elucidate the magnitude of problem and the clinical course of invasive meningococcal infection from 13 government hospitals in Thailand between 1994 and 1999. Thirty-six strains of Neisseria meningitidis were isolated from 16 blood and 24 cerebrospinal fluid specimens; 4 patients had positive culture in both blood and CSF. Of the 16 strains, 9 (56.3%) were serogroup B. Seventy-one and eighty-four percent of the isolates were susceptible to penicillin and cefotaxime/ceftriaxone respectively. Five out of six penicillin-nonsusceptible strains were found to be relatively resistant to penicillin with the MIC of 0.125 microg/ml. Of 33 patients whose medical records were available, 21 were males and 12 were females, with a mean age of 11.2 years. Fifteen patients (45.5%) presented with meningococcemia and 18 patients (54.5%) presented with meningococcal meningitis. Hypotension and purpura were found in 24.2% and 33.3% of patients respectively. The overall mortality rate was 9.1%. In conclusion, meningococcal disease is not common in Thailand, meningococcemia is a life-threatening condition whereas meningococcal meningitis is much less severe. The prevalence of meningococci relatively resistant to penicillin seems to be increasing.