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Epidemiology of Meningitis in the Valencian Community (Spain), 1995-2007: Hospital Admissions Incidence, Causative Agents, and Mortality

Andreu-Ballester, Juan Carlos MD*; González-Sánchez, Antonio MD; Ballester, Ferran PhD‡§∥; Almela-Quilis, Amadeo MD*; Colomer-Rubio, Enrique MD*; Sanchez-Roy, Rafael MD; Peñarroja-Otero, Carlos PhD#**

Infectious Diseases in Clinical Practice: January 2010 - Volume 18 - Issue 1 - p 29-36
doi: 10.1097/IPC.0b013e3181c5eedb
Original Articles

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.

From the *Research Unit and Department of Emergency Medicine, and †Department of Documentation and Admission, Arnau de Vilanova Hospital; ‡Unit of Epidemiology and Statistics, Valencia School of Studies for Health (EVES), Valencia; §Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Barcelona; ∥Center of Research in Public Health (CSISP); ¶Department of Neurology, Arnau de Vilanova Hospital; #Internal Medicine Unit, Hospital Casa de Salud; and **Catholic University of Valencia (UCV), Valencia, Spain.

Reprints: Juan Carlos Andreu Ballester, MD, c/Juan Ramón Jiménez, 29-14a, 46006 Valencia, Spain. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2010 Lippincott Williams & Wilkins, Inc.