Etiological and epidemiological features of acute meningitis or encephalitis in China: a nationwide active surveillance study

作者：Liping Wang, Yang Yuan, Yingle Liu, Qing‐Bin Lu, Lusha Shi, Xiang Ren, Shi-Xia Zhou, Xiao‐Ai Zhang, Xiao‐Ai Zhang, Xin Wang, Yifei Wang, Sheng-Hong Lin, Cuihong Zhang, Mengjie Geng, Jun Li, Shi-Wen Zhao, Zhigang Yi, Xiao Chen, Zuosen Yang, Lei Meng, Xinhua Wang, Ai‐Li Cui, Shengjie Lai, Meng-Yang Liu, Yuliang Zhu, Wenbo Xu, Yu Chen, Zhenghong Yuan, Mengfeng Li, Liuyu Huang, Huaiqi Jing, Zhongjie Li, Wei Liu, Li‐Qun Fang, Jianguo Wu, Simon I Hay, Weizhong Yang, George F. Gao · 发表于：The Lancet Regional Health - Western Pacific · 年份：2022 · DOI：10.1016/j.lanwpc.2021.100361 · 被引用次数：42 · 研究领域：Bacterial Infections and Vaccines、Infectious Encephalopathies and Encephalitis、Herpesvirus Infections and Treatments

Background Acute meningitis or encephalitis (AME) results from a neurological infection causing high case fatality and severe sequelae. AME lacked comprehensive surveillance in China. Methods Nation-wide surveillance of all-age patients with AME syndromes was conducted in 144 sentinel hospitals of 29 provinces in China. Eleven AME-causative viral and bacterial pathogens were tested with multiple diagnostic methods. Findings Between 2009 and 2018, 20,454 AME patients were recruited for tests. Based on 9,079 patients with all-four-virus tested, 28.43% (95% CI: 27.50%‒29.36%) of them had at least one virus-positive detection. Enterovirus was the most frequently determined virus in children <18 years, herpes simplex virus and Japanese encephalitis virus were the most frequently determined in 18−59 and ≥60 years age groups, respectively. Based on 6,802 patients with all-seven-bacteria tested, 4.43% (95% CI: 3.94%‒4.91%) had at least one bacteria-positive detection, Streptococcus pneumoniae and Neisseria meningitidis were the leading bacterium in children aged <5 years and 5−17 years, respectively. Staphylococcus aureus was the most frequently detected in adults aged 18−59 and ≥60 years. The pathogen spectrum also differed statistically significantly between northern and southern China. Joinpoint analysis revealed age-specific positive rates, with enterovirus, herpes simplex virus and mumps virus peaking at 3−6 years old, while Japanese encephalitis virus peaked in the ≥60 years ol...