POJAVNOST I ETIOLOGIJA GNOJNIH MENINGITISA U DJECE PRIJE I NAKON UVOĐENJA HIB CJEPIVA

Objective: To determine the number and etiology of purulent meningitis in the period from 1999-2013 and collect and compare data on the clinical presentation and complications of purulent meningitis in children from 0-5 years of age in the period before and after the introduction of Hib vaccine in the obligatory vaccination schedule. Materials and Methods: Data on purulent meningitis in children aged 0-5 years who were treated at the Clinic for Infectious Diseases, University Hospital Split in period from 1999-2013 was collected retrospectively. Children with positive culture of cerebrospinal fluid and / or blood culture were included. Study also included children with undetermined etiology of meningitis that had cytological and biochemical findings of cerebrospinal fluid consistent with purulent meningitis. The data collected were compared in the period before and after the introduction of mandatory vaccination against H. influenzae type b in 2002. Statistical analysis was performed using χ²-test. Results: A significant decrease in the incidence of purulent meningitis caused by H. influenzae was proven during the first five years of compulsory vaccination. In last 6 years purulent meningitis caused by H. influenzae practically no longer appeared. During the study period significant decrease in the number of purulent meningitis, which was diagnosed 24 hours after onset of symptoms was shown, as well as the reduction of the number of complications caused by purulent meningitis. Conclusion: The introduction of Hib vaccine has led to a drastic decline in the incidence of purulent meningitis caused by Haemophilus influenzae type b. During this period there was a significant reduction in the number of purulent meningitis which was diagnosed 24 hours after the onset of symptoms and reduction of the number of complications caused by purulent meningitis.