Clinical and Epidemiologic Features of Meningococcal Infections in Incheon, Korea / 감염과화학요법

ABSTRACT

BACKGROUND: Meningococcal diseases occur worldwide and there are several case reports and reports on carriage rates in Korean military personnel. However, there are only few data on meningococcal diseases in the civilian. This study was performed to determine the incidence, clinical features of meningococcal disease, and a pharyngeal carriage rate of meningococcus in nonmilitary persons in metropolitan Incheon, Korea. MATERIALS AND METHODS: Patients with meningococcal diseases were searched by the following methods: discharge diagnosis of 'meningococcal infection' or 'meningococcal meningitis' or 'meningococcal sepsis'; positive cases in bacterial culture of blood or cerebrospinal fluid (CSF); positive meningococcal antigen in CSF. Two university hospitals in Incheon were participated and medical records of the meningococcal infection were reviewed. A survey of pharyngeal carriage of N. meningitidis was done at a high school by throat culture. RESULTS: A total of 15 cases of meningococcal diseases were identified. Ten cases were from Inha University hospital from January 1997 to May 2004, and five cases were from Gacheon Medical School Gil hospital from January 2002 to May 2004. Neisseria meningitidis was isolated in 11 cases and the remaining 4 cases were diagnosed by detecting of meningococcal antigen. The minimal annual incidence rates of meningococcal infection in metropolitan Incheon city ranged from 0.077/ 100,000 to 0.192/100,000. Majority of the patients were under 15 years old and occurred between October to May. The diagnosis was meningitis in 14 patients and sepsis in one patient. Patient with sepsis died but all the other patients recovered.Two among five strains produced beta-lactamase. Throat cultures from 78 high school students showed Neiserria meningitidis in 6 (7.7%) students. CONCLUSION: Epidemiologic data and clinical features were similar to other reports from developed countries. However antimicrobial resistance rate may be higher. Further studies on meningococcal serogroup or sequence type, antimicrobial resistance, and prevalence of antibody against meningococcus are needed.