To study the incidence of all meningitis in the Valencian community (Spain) during a period of 13 years (1995-2007).
Methods: We collected data on discharge diagnoses of meningitis in all public hospitals in the Valencian community. The changes over time in incidence, type of microorganism, comorbidity, recurrent meningitis, and mortality were examined.
Results: We identified 9240 cases of meningitis during the study period. The age-standardized incidence rate was 16.77 cases per 100,000 population per year. The incidence was higher for men than for women. Viruses and meningococcus were the most frequent causes of global meningitis. In nosocomial meningitis, Staphylococcus (5.6%) and Escherichia coli (3.7%) are the more common bacteria compared with the general incidence. Cryptococcus (24.1%) and mycobacteria (26.4%) are the most common bacteria in the meningitis of immunocompromised patients. The mortality rate in global meningitis was 6.1%, whereas in nosocomial meningitis and in immunodeficiency, the mortality rates were 15.3 % and 18.2 %, respectively. The prevalence of recurrent meningitis was 4%.
Conclusions: The frequency of hospital admissions for meningitis in the Valencian community is far from negligible, and rates stay stable over time. Incidence is clearly higher among men. The mortality rate was 6% of the cases. The highest mortality was due to fungi associated with cryptococcal meningitis in patients with human immunodeficiency virus. Severe underlying disease is the most important risk factor for death.