Published November 9, 2012
Bacterial meningitis is a devastating disease that is associated with substantial mortality and morbidity. Major causative bacteria are Streptococcus pneumoniae and Neisseria meningitis, with case-fatality rates of 30% and 7% in higher-income countries. In resource-poor settings, fatality rates can be as high as 50%. Neurological sequelae, including hearing loss, developmental disorders, and neuropsychological impairment are reported to occur in up to half of survivors of bacterial meningitis. Although routine vaccination against the three most common causative bacteria had considerable impact on the occurrence of bacterial meningitis, there are an estimated 1·2 million cases each year worldwide resulting in 180,000 deaths among children aged 1–59 months in 2010.
This Series updates current knowledge of three important aspects of bacterial meningitis: dilemmas in making the diagnosis, advances in treatment, and the impact of vaccines on bacterial meningitis worldwide. The series reveals substantial progress in clinical diagnostics, molecular diagnostic methods, adjunctive anti-inflammatory treatments, and preventive strategies. It also highlights evolving challenges: global emergence of multi-drug resistant bacteria, a lack of randomized studies evaluating treatment strategies, and a lack of progress in resource-poor countries, where the urgency of the problem is highest. Further introduction of conjugate vaccines, especially in parts of the world with the highest disease burden, is imperative for the reduction of the burden of acute bacterial meningitis worldwide.
Progress and challenges in bacterial meningitis
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