Epidemiological survey of bacterial meningitis in France in 1995-1997.

Objective - We had for aim to confirm the therapeutical recommendations of the French Infectious Diseases Society, through an epidemiological study assessing the incidence of various bacteria in primary bacterial meningitis, the susceptibility patterns for common species and the impact of Haemophilus influenzae type b vaccine. Material and methods - We recorded the cases of acute purulent meningitis in six French departments (total population 7.2 millions) between April 1995 and April 1997 Reference centers were defined in every department. They had to report all the cases (bacteria was isolated, either from the CSF; either from blood) occurring in their departments. Results - Two hundred and seven cases were recorded concerning patients over a month of age. Streptococcus pneumoniae and Neisseria meningitidis were the more frequent species (43% and 35.2% of the cases respectively) with an annual fetal incidence 0.75/100 000 and 0.63/100 000, respectively. S. pneumoniae was the predominant pathogen among adults and N. meningitidis among children between two and 19 years of age. 28% of S. pneumoniae s were less susceptible to penicillin and 19.5% were resistant 21% of N. meningitidis were less susceptible to penicillin. The other pathogenic bacteria were Listeria monocytogenes (5.3%), Mycobacterium tuberculosis (4.4%), Escherichia coli (4.8%), Streptococcus agalactiae (3.4%), and Haemophilus influenzae(4.8%). The annual incidence of H. influenzae meningitis is 0.08/100 000 for ail cases and 0.82/100 000 for cases in children under five years of age, illustrating the impact of H. influenzae type b vaccine in our country (C) 2000 Editions scientifiques et medicales Elsevier SAS.