Incidence, epidemiology and etiology of acute meningitis in Mures County – an observational study

Abstract Background: Meningitis are multiple aetiology disorders characterized by infectious triggered inflammation of the meningeal serrosa manifesting as an acute systemic illness with variable evolution from cure to death. The objectives of this study were the evaluation of incidence, epidemiologic and diagnostic aspects of the acute meningitis in a well define region. Methods: we have designed an observational retrospective study that included a number of 165 consecutively admitted patients with the diagnosis of meningitis at the Targu-Mures Infectious Disease Clinic, Romania, from January 1st to December 31st 2011. We have compared cases of confirmed meningitis vs. meningismus, and meningeal reaction. We kept track of the demographic aspects, the annual and seasonal distribution of cases. The diagnosis of meningitis was established by examination of the cerebrospinal fluid such as: aspect, pleocytosis, biochemical reactions, wet mounts, Latex agglutination tests, serological reactions, cultures and antibiotic resistance testing (when needed). Results: the majority of the patients were male, from rural areas. The mean age of patients with bacterimeningitis was 36 years old, and that of viral meningitis cases was 20 years old. The acute meningitis incidence in 2011 was 19.73 cases/100.000 inhabitants. 26 patients (15.76%) of the observed group were diagnosed with bacterial meningitis, and 63 cases (38.18%) with viral meningitis. The most common cause for bacterial meningitis were Gram-positive cocci, and for viral meningitis, the varicella-zoster virus. Conclusions: in 2011, the incidence of acute meningitis in our region has not decreased significantly compared to previous studies. In the case of bacterial meningitis, the etiologic agent was identified in a small proportion, possibly because of antibiotic treatment administered before the admission, also observing an increase in antibiotic resistance of the identified agents.