Open forum infectious diseases · 2026
Nationwide Trends in Hospitalizations and Clinical Outcomes for Meningitis and Encephalitis: A 10-year Swiss Population-based Study.
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Essmann Lennart, Gregoriano Claudia, Schuetz Philipp, Conen Anna, Kutz Alexander
Аннотация
BACKGROUND: Meningitis and encephalitis are severe infections of the central nervous system (CNS) causing substantial morbidity and mortality. Contemporary nationwide data on epidemiological trends and outcomes are limited.
METHODS: We conducted a nationwide, retrospective cohort study using hospital discharge data from the Swiss National Health Registry. All hospitalizations for infectious meningitis and encephalitis between January 2012 and December 2021 were included. We assessed temporal and age-specific trends, pathogen distributions, and in-hospital outcomes using descriptive statistics and multivariable regression analysis.
RESULTS: Among 23 426 identified hospitalizations (10 160 for meningitis; 13 266 for encephalitis), the overall incidence of CNS infections increased from 22 to 34 per 100 000 inhabitants between 2012 and 2019, followed by a marked decline in 2020-2021. For meningitis, this decline was driven by reductions in pneumococcal (∼65%) and enteroviral (∼90%) infections. Enteroviral and streptococcal meningitis rates were highest in children younger than 10 years, whereas Streptococcus pneumoniae, Listeria monocytogenes, tick-borne encephalitis virus, and varicella-zoster virus infections were more frequent in adults older than 50 years. Compared with viral meningitis, bacterial meningitis was associated with higher odds of intensive care unit admissions (odds ratio [OR], 8.40; 95% confidence interval [CI], 7.29 to 9.67) and in-hospital mortality (OR 4.23; 95% CI, 2.95 to 6.05). Similar risk patterns were observed for bacterial encephalitis.
CONCLUSIONS: Nationwide hospitalization rates for CNS infections showed distinct temporal and age-specific patterns. Bacterial infections, particularly among older adults, were associated with substantially worse outcomes, underscoring the importance of early diagnosis, optimized treatment, and preventive strategies, including vaccination.
METHODS: We conducted a nationwide, retrospective cohort study using hospital discharge data from the Swiss National Health Registry. All hospitalizations for infectious meningitis and encephalitis between January 2012 and December 2021 were included. We assessed temporal and age-specific trends, pathogen distributions, and in-hospital outcomes using descriptive statistics and multivariable regression analysis.
RESULTS: Among 23 426 identified hospitalizations (10 160 for meningitis; 13 266 for encephalitis), the overall incidence of CNS infections increased from 22 to 34 per 100 000 inhabitants between 2012 and 2019, followed by a marked decline in 2020-2021. For meningitis, this decline was driven by reductions in pneumococcal (∼65%) and enteroviral (∼90%) infections. Enteroviral and streptococcal meningitis rates were highest in children younger than 10 years, whereas Streptococcus pneumoniae, Listeria monocytogenes, tick-borne encephalitis virus, and varicella-zoster virus infections were more frequent in adults older than 50 years. Compared with viral meningitis, bacterial meningitis was associated with higher odds of intensive care unit admissions (odds ratio [OR], 8.40; 95% confidence interval [CI], 7.29 to 9.67) and in-hospital mortality (OR 4.23; 95% CI, 2.95 to 6.05). Similar risk patterns were observed for bacterial encephalitis.
CONCLUSIONS: Nationwide hospitalization rates for CNS infections showed distinct temporal and age-specific patterns. Bacterial infections, particularly among older adults, were associated with substantially worse outcomes, underscoring the importance of early diagnosis, optimized treatment, and preventive strategies, including vaccination.