Acute bacterial meningitis (ABM) is a public health problem. The disease has reemerged after the introduction of pneumococcal conjugate vaccines (PCVs) due to an increase in serotypes that are not covered. The objective was to determine the changes in the disease incidence before and after the introduction of the 10-valent vaccine (PCV10) in Colombia.

This multicenter study was conducted in 17 hospitals in Colombia. Data were collected from January 2008 to December 2019 in 10 hospitals in Bogotá and from January 2017 to December 2019 in seven hospitals in Cali, Medellín and Cartagena. The data were grouped into three periods: 2008–2011, 2012–2015, and 2016-2019.

Of the 706 cases of invasive pneumococcal disease, 81 (11.4%) corresponded to meningitis. The relative incidence in Bogotá in the first period was 0.6 per 100,000 patients ≤ 5 years, decreased to 0.4 per 100,000 patients ≤ 5 years in the second period and increased in the third period to 0.7 per 100,000 patients ≤ 5 years. Serotypes covered by PCV10 decreased from 75 to 9.1%, with Spn19A (31.8%) and Spn34 (13.6%) emerging in the third period. Increased resistance to penicillin (13 to 37%) and to ceftriaxone (5.9 to 16%) was due to the emergence of multidrug-resistant Spn19A. The total mortality rate was 23.5% and increased from 12 to 33%.

ABM due to pneumococcus has high morbidity and mortality rates. Reemergence of the disease has been observed due to the inclusion of polymerase chain reaction (PCR) for diagnosis and replacement of circulating serotypes after the introduction of PCV10, with an increase in Spn19A, which causes death and exhibits antimicrobial resistance. Continued surveillance is needed.

急性细菌性脑膜炎 (ABM) 是一个公共卫生问题。由于未涵盖的血清型增加，在引入肺炎球菌结合疫苗 (PCV) 后，该疾病再次出现。目的是确定在哥伦比亚引入 10 价疫苗 (PCV10) 前后疾病发病率的变化。

这项多中心研究在哥伦比亚的 17 家医院进行。数据于 2008 年 1 月至 2019 年 12 月在波哥大的 10 家医院以及 2017 年 1 月至 2019 年 12 月在卡利、麦德林和卡塔赫纳的 7 家医院收集。数据分为三个时期：2008-2011 年、2012-2015 年和 2016-2019 年。

在 706 例侵袭性肺炎球菌病中，81 例（11.4%）对应于脑膜炎。波哥大的相对发病率在第一个时期为每 100,000 名≤ 5 年的患者中 0.6 人，在第二个时期下降到每 100,000 名≤ 5 年的患者中 0.4 起，在第三时期增加到每 100,000 名≤ 5 年的患者中 0.7 起。PCV10 覆盖的血清型从 75% 下降到 9.1%，其中 Spn19A（31.8%）和 Spn34（13.6%）出现在第三阶段。对青霉素（13% 至 37%）和头孢曲松（5.9% 至 16%）的耐药性增加是由于多重耐药 Spn19A 的出现。总死亡率为 23.5%，从 12% 增加到 33%。

肺炎球菌引起的 ABM 具有高发病率和死亡率。由于在引入 PCV10 后将聚合酶链反应 (PCR) 用于诊断和替代循环血清型，已观察到该疾病的再次出现，Spn19A 增加，导致死亡并表现出抗菌素耐药性。需要持续监测。