Temporal patterns of asymptomatic SARS-CoV-2 infection among pediatric population in Japan: A 3-year analysis.

To elucidate the seroprevalence and rate of asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Japanese children, serological analysis was performed using serum samples collected from March 2020 to February 2023. A total of 1493 serum samples were collected during the first study period (March 2020 to February 2021). None of the serum samples was positive for SARS-CoV-2 antibody. In the second period (March 2021 to February 2022), seven of the 1055 patients (0.7%) experienced SARS-CoV-2 infection. The third period (March 2022 to February 2023) was divided into three terms: from March to June 30, 2022; from July to October 2022; and from November 2022 to February 2023. The seroprevalence gradually increased throughout this period, with rates of 6.0%, 18.6%, and 30.4% in the three terms, respectively. Pediatric cases of asymptomatic SARS-CoV-2 infection occurred after the surge of Omicron variants. Since none of the SARS-CoV-2 antibody-positive patients had a previous history of coronavirus disease 2019, the seroprevalence rate in this study may represent the rate of asymptomatic infection.

Rotavirus Vaccination Can Be Performed Without Viral Dissemination in the Neonatal Intensive Care Unit.

Background: This study was conducted to assess the transmissibility of rotavirus vaccine strains after rotavirus vaccination in a neonatal intensive care unit (NICU). Methods: Pentavalent (RV5) or monovalent (RV1) rotavirus vaccine was administered to infants admitted to the NICU. Nineteen vaccinated infants and 49 unvaccinated infants whose beds were located in close proximity to the vaccinated infants were enrolled in this study. Dissemination and fecal shedding of vaccine viruses within the NICU were examined using real-time reverse transcription-polymerase chain reaction. Results: Shedding of the vaccine strain was detected in all 19 vaccinated infants. RV5 virus shedding started 1 day after the first vaccination and persisted for 8 days after the first vaccination, and viral shedding terminated by day 5 after administration of the second RV5 dose. The kinetics of RV1 virus shedding differed among vaccinated infants. The duration of RV1 virus shedding was longer after the first vaccination than after the second vaccination. In contrast to the vaccinated infants, no vaccine virus genomes were detected in any of the stool samples collected from the 49 unvaccinated infants. Conclusions: This study is direct evidence of no transmission of rotavirus vaccine strains between vaccinated infants and unvaccinated infants in close proximity within a NICU.

Role of matrix metalloproteinases in the pathogenesis of childhood gastroenteritis.

Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been implicated in the pathogenesis of gastrointestinal diseases, such as rotavirus gastroenteritis (GE). Kinetics of these biomarkers were examined in paired serum samples collected from bacterial enteritis patients with Campylobacter (n = 2) and Salmonella (n = 4) and viral GE patients with rotavirus (n = 27), norovirus (n = 25), and adenovirus (n = 11). At the time of hospital admission, all viral GE patients demonstrated increased MMP-9 and decreased MMP-2 and TIMP-2 serum levels. In contrast to viral GE patients, serum MMP-9 levels were not elevated at the time of hospital admission but elevated at the time of discharge; serum MMP-2 and TIMP-2 levels were decreased both at the time of admission and discharge in bacterial enteritis patients. Interestingly, the kinetics of serum MMP-2, MMP-9, and TIMP-2 levels were similar among the viral GE patients but distinct from bacterial enteritis patients. Thus, the involvement of MMPs and TIMPs in the pathophysiology of gastrointestinal symptoms likely varies depending on the etiological agent. Further studies are required to verify whether the extent of the bacterial enteritis or age of the patients influences these serum biomarkers. J. Med. Virol. 88:1341-1346, 2016. © 2016 Wiley Periodicals, Inc.

A Novel IgM-capture enzyme-linked immunosorbent assay using recombinant Vag8 fusion protein for the accurate and early diagnosis of Bordetella pertussis infection.

An ELISA that measures anti-PT IgG antibody has been used widely for the serodiagnosis of pertussis; however, the IgG-based ELISA is inadequate for patients during the acute phase of the disease because of the slow response of anti-PT IgG antibodies. To solve this problem, we developed a novel IgM-capture ELISA that measures serum anti-Bordetella pertussis Vag8 IgM levels for the accurate and early diagnosis of pertussis. First, we confirmed that Vag8 was highly expressed in all B. pertussis isolates tested (n = 30), but little or none in other Bordetella species, and that DTaP vaccines did not induce anti-Vag8 IgG antibodies in mice (i.e. the antibody level could be unaffected by the vaccination). To determine the immune response to Vag8 in B. pertussis infection, anti-Vag8 IgM levels were compared between 38 patients (acute phase of pertussis) and 29 healthy individuals using the anti-Vag8 IgM-capture ELISA. The results revealed that the anti-Vag8 IgM levels were significantly higher in the patients compared with the healthy individuals (P < 0.001). ROC analysis also showed that the anti-Vag8 IgM-capture ELISA has higher diagnostic accuracy (AUC, 0.92) than a commercial anti-PT IgG ELISA kit. Moreover, it was shown that anti-Vag8 IgM antibodies were induced earlier than anti-PT IgG antibodies on sequential patients' sera. These data indicate that our novel anti-Vag8 IgM-capture ELISA is a potentially useful tool for making the accurate and early diagnosis of B. pertussis infection.

Phase II and III Clinical Studies of Diphtheria-Tetanus-Acellular Pertussis Vaccine Containing Inactivated Polio Vaccine Derived from Sabin Strains (DTaP-sIPV).

BACKGROUND: Phase II and III clinical studies were conducted to evaluate immunogenicity and safety of a novel DTaP-IPV vaccine consisting of Sabin inactivated poliovirus vaccine (sIPV) and diphtheria-tetanus-acellular pertussis vaccine (DTaP). METHODS: A Phase II study was conducted in 104 healthy infants using Formulation H of the DTaP-sIPV vaccine containing high-dose sIPV (3, 100, and 100 D-antigen units for types 1, 2, and 3, respectively), and Formulations M and L, containing half and one-fourth of the sIPV in Formulation H, respectively. Each formulation was administered 3 times for primary immunization and once for booster immunization. A Phase III study was conducted in 342 healthy infants who received either Formulation M + oral polio vaccine (OPV) placebo or DTaP + OPV. The OPV or OPV placebo was orally administered twice between primary and booster immunizations. RESULTS: Formulation M was selected as the optimum dose. In the Phase III study, the seropositive rate was 100% for all Sabin strains after primary immunization, and the neutralizing antibody titer after booster immunization was higher than in the control group (DTaP + OPV). All adverse reactions were clinically acceptable. CONCLUSIONS: DTaP-sIPV was shown to be a safe and immunogenic vaccine. CLINICAL TRIALS REGISTRATION: JapicCTI-121902 for Phase II study, JapicCTI-101075 for Phase III study (http://www.clinicaltrials.jp/user/cte_main.jsp).

Varicella vaccination in Japan: necessity of implementing a routine vaccination program.

Varicella-zoster virus (VZV) is the causative agent of varicella (chickenpox). It shows extremely high infectivity and is spread by airborne, droplet, and contact transmission. After a person is infected with VZV, the virus remains dormant in the dorsal root ganglia, but can be reactivated under circumstances where specific immunity declines, leading to the development of herpes zoster (shingles). Although varicella is a disease that usually resolves after about 1 week, it can cause various complications such as secondary bacterial skin infection, pneumonia, and encephalitis. In addition, varicella can become severe in immunocompromised persons, whereas VZV infection transmitted from an infected mother can cause the congenital varicella syndrome or serious neonatal varicella. In 1974, a live varicella vaccine (Oka strain) was developed in Japan for the prevention of varicella, and clinical trials performed during the development were mainly focused on high-risk children. In 1985, the Oka strain was recognized as the best varicella vaccine strain by the World Health Organization (WHO). Today, all the varicella vaccines used worldwide to immunize approximately 32 million people annually contain the Oka strain. In Japan, it has been commercially available since 1987 for the voluntary vaccination program, in which children over the age of 1 year with no history of previous varicella infection receive a single dose. In addition to healthy children, this vaccine can be used for immunocompromised children, and vaccination of elderly persons can also be done to enhance their immunity against VZV. Varicella vaccine is a highly safe vaccine with sufficient immunogenicity. The preventive effect of single-dose vaccination is believed to be approximately 80 % for all types of varicella, including mild cases; it is 95 % or greater for moderate to severe disease. Implementation of a two-dose vaccination schedule has proved to be effective against breakthrough varicella, which is observed in approximately 20-30 % of children vaccinated with a single dose. Because it is administered as part of the voluntary vaccination program, the varicella vaccination coverage rate in Japan has remained low until recently at around 20-30 %, with no sign of a decrease in the number of varicella patients. It is necessary to maintain a vaccination rate of 90 % or higher to prevent varicella epidemics. To achieve this goal, implementation of a routine vaccination program for varicella and introduction of a two-dose vaccination schedule, which is more effective than a single-dose schedule, would be highly desirable.

[Immunogenicity of additional varicella vaccination 3-5 years after the initial vaccination].

Additional varicella vaccination was carried out targeting 16 subjects who had immune adherence hemagglutination (IAHA) seroconversion following the initial varicella vaccination and did not contract breakthrough varicella after the initial vaccination. The median ages at the initial and additional vaccination were 2.1 (1.1-6.9) years old and 6.1 (4.4-10.5) years old, respectively. The mean interval between the initial and additional vaccination was 4.0 (3.2-5.2) years. IAHA and glycoprotein-based enzyme-linked immunosorbent assay (gpELISA) antibody titers were measured just before and 4-6 weeks after the additional vaccination. Side reaction was surveyed at four weeks after the additional vaccination, and compared with the results at the initial vaccination. IAHA and gpELISA seroconversion rates at the initial vaccination were 100% and 88% respectively. Prior to the additional vaccination, IAHA antibody titers significantly decreased in 50% of the subjects, and became negative in 38% of the subjects. On the other hand, a significant increase in IAHA antibody titers was observed in 25% of the subjects, and this is assumed to be the result of a subclinical infection after the initial vaccination. The positive rate of both antibodies after the additional vaccination was 100%, the mean IAHA antibody titer (Log2) after the initial/additional vaccination in seropositive subjects was 4.6/6.5, and the mean gpELISA antibody titer (Log10) was 2.3/4.0. The mean IAHA and gpELISA antibody titers were higher after the additional vaccination than after the initial vaccination (p < 0.01, p < 0.01). This is considered to be the booster effect due to the additional vaccination. At 0-2 days after the additional vaccination, a rash at the injection site was observed in 56% of the subjects, higher than the incidence after the initial vaccination (13%) (p < 0.05), but no severe systemic side reactions were observed at either the initial or the additional vaccination. In conclusion, an additional varicella vaccination 3-5 years after the initial vaccination is thought to have greater immunogenicity and is considered effective.

Anti-varicella-zoster virus antibody titers and seroprotection status from before the first dose of varicella vaccination to before entering elementary school in one region in Japan.

OBJECTIVE: We aimed to examine changes in anti-varicella-zoster virus (VZV) antibody titers and seroprotection status from before the first dose of vaccination to before 7 years old entering elementary school in children who received the routine two-dose varicella vaccination. METHODS: Participants were 37 healthy children who received the routine two-dose varicella vaccination at our hospital. A total of five serum samples per child were collected immediately before and 4-6 weeks after each dose of the vaccination and in the year before entry to elementary school. We measured anti-VZV antibody titers by immune adherence hemagglutination (IAHA) method and glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). A positive antibody titer and the seroprotection level were set as ≥2-fold and ≥16-fold, respectively, for IAHA antibody and as ≥50 units and ≥105 units, respectively, for gpELISA-IgG antibody. RESULTS: The rates of IAHA antibody positivity in the five samples (in order of collection) were 0%, 65%, 38%, 100%, and 59%, and the rates of seroprotection were 0%, 43%, 8%, 100%, and 43%. The rates of gpELISA-IgG antibody positivity were 8%, 81%, 89%, 100%, and 100%, and the rates of seroprotection were 5%, 54%, 70%, 100%, and 89%. The mean IAHA antibody titer and mean gpELISA-IgG antibody titer before entering elementary school were both lower than the respective titers obtained after the second vaccination (both p < 0.01). CONCLUSIONS: Routine two-dose varicella vaccination leads to good antibody production, but titers of acquired antibodies decrease before children enter elementary school.

Correlation between serum matrix metalloproteinase and antigenemia levels in patients infected with rotavirus.

Rotavirus (RV) antigenemia has been reported in patients with gastroenteritis; however, the exact mechanism remains unclear. In order to elucidate the mechanism of RV antigenemia, an association between RV antigenemia and matrix metalloproteinase (MMP) were analyzed. The object of this study was to elucidate the role of MMPs and tissue inhibitors of metalloproteinases (TIMPs) in the pathogenesis of RV antigenemia. Forty children admitted to hospital with RV gastroenteritis were enrolled in this study. Paired serum samples were collected at the time of admission and discharge. Enzyme-linked immunosorbent assays (ELISA) were used to detect serum concentrations of viral antigens, MMP-1, -2, -9, -13, TIMP -1, and -2. Cytokines were measured using flow cytometric beads array. RV antigens were significantly higher in serum collected at the time of admission than discharge (P < 0.001). MMP-9 concentrations were significantly higher in serum collected at the time of admission than discharge (P < 0.001). MMP-2 concentrations were significantly lower in serum collected at the time of admission than discharge (P < 0.001). A weak but a significantly positive association (P = 0.034) was observed between RV antigen and MMP-9 in serum collected at the time of admission, and inverse association was observed between RV antigen and MMP-2. In addition, a weak but significantly positive association (P = 0.002) was observed between IL-6 and MMP-9. These data suggest that MMPs may contribute to the pathogenesis of RV antigenemia.

Clinical characteristics of norovirus gastroenteritis among hospitalized children in Japan.

Acute diarrhea is one of commonest pediatric illnesses worldwide. Although the importance of norovirus as a cause of gastroenteritis outbreaks is well documented, its role in sporadic acute gastroenteritis is not well characterized. The aim of this study was to clarify the prevalence and clinical characteristics of norovirus gastroenteritis among hospitalized children. Between November 2007 and April 2008, inpatients under 12 years of age with acute gastroenteritis in a single hospital in Japan were investigated. A stool sample from each patient was screened for enteropathogenic bacteria and tested by reverse transcription polymerase reaction for norovirus and by an immunochromatographic method for rotavirus and enteric adenoviruses. The clinical features of children with norovirus gastroenteritis were compared with those of children with rotavirus and children without noro- or rotovirus infections. Among 107 patients included in this study, norovirus and rotavirus were detected in 36 (34%) and 37 (35%) patients, respectively. Compared with rotavirus enteritis, the duration of vomiting and diarrhea was significantly longer, and serum C-reactive protein concentrations were higher, in patients with norovirus enteritis. Norovirus was detected as frequently as rotavirus in hospitalized pediatric gastroenteritis patients. Our results suggest that norovirus gastroenteritis among hospitalized young children is not less severe than rotavirus gastroenteritis.

Detection of Mycoplasma pneumoniae by loop-mediated isothermal amplification (LAMP) assay and serology in pediatric community-acquired pneumonia.

Rapid diagnosis of Mycoplasma pneumoniae pneumonia is required for treatment with effective antimicrobial agents without delay; however, this capacity has not yet been established in clinical practice. Recently, a novel nucleic acid amplification method termed loop-mediated isothermal amplification (LAMP) has been used to rapidly diagnose various infectious diseases. In this study, we prospectively evaluated the efficacy of the LAMP assay to rapidly diagnose M. pneumoniae pneumonia in clinical practice. Three hundred sixty-eight children (median age, 3.8 years; range, 0.1-14.3 years) admitted to our hospital between April 2009 and March 2010 for community-acquired pneumonia were enrolled in this study. We obtained throat swabs on admission to detect M. pneumoniae DNA and paired serum samples on admission and at discharge to assay M. pneumoniae antibody titers. M. pneumoniae pneumonia was diagnosed by either a positive LAMP assay or a fourfold or greater increase in antibody titer. Overall, 46 children (12.5% of the patients with pneumonia) were diagnosed with M. pneumoniae pneumonia; of these, 27 (58.7%) were aged less than 6 years. Of the aforementioned 46 children, 38 (82.6%) and 37 (80.4%) were identified by LAMP and serology, respectively. When the results of serology were taken as the standard, the sensitivity and specificity and positive and negative predictive values of the LAMP assay were 78.4%, 97.3%, 76.3%, and 97.6%, respectively. We concluded the LAMP assay may be useful for rapid diagnosis of M. pneumoniae pneumonia.

[A study for the necessity of virus titer of varicella vaccine presently used].

Recently available varicella vaccine titers are several dozen times higher than the formulation standard in accompanying information, i.e., > or = 1,000 PFU/dose. We investigated changes in immunogenicity associated with vaccination using a reduced dose whose virus titer was close to that used when the vaccine was developed, and examined the need for the virus titer presently used. In a non blinded study of 43 children with no history of varicella infection, we administered 0.1 mL of varicella vaccine (1/5 of the normal dose) to 20 children 1 year 0 month to 4 years 5 months old (median: 1 year 5 months) and the standard 0.5mL dose to 23 children 1 year 2 months to 3 years 7 months old (median: 1 year 9 months). We measured IAHA and gpELISA antibody titer before vaccination and 4 to 6 weeks after vaccination. We defined "positive" as > or = 2 fold of IAHA titer and > or = 50 U of gpELISA antibody titer. We administered an additional 0.5mL of varicella vaccine to children whose IAHA titer failed to show seroconversion and remeasured antibody titer 4 to 6 weeks after revaccination. IAHA seroconversion was 25.0% (5/20) and gpELISA seroconversion 55.0% (11/20) in the 0.1 mL vaccination group, which was lower than that of 76.2% (16/21) and 87.0% (20/23), IAHA p < 0.01, gpELISA p < 0.05, in the 0.5 mL vaccination group. We administered an additional vaccination to 19 children--15 in the 0.1 mL vaccination group and 4 in the 0.5 mL vaccination group-with 100% seroconversion for both methods. Mean antibody titer after revaccination in the 0.1 mL vaccination group (IAHA 2 (6.0), gpELISA 10 (3.7)) was higher than those in the 0.5mL vaccination group who seroconverted following initial vaccination (IAHA 2(4.5), gpELISA 10(2.6)) (p < 0.01). We also measured virus titer in the remaining vaccine following vaccination of 0.1 mL (n = 20), and estimated virus titer administered to the 0.1 mL vaccination group to be 2,600-6,400 PFU/ dose. Varicella vaccine immunogenicity decreased if dosage was reduced to 1/5 of the standard dose, indicating that the present virus titer is necessary to maintain adequate immunogenicity. An additional administration of the standard dose to children who failed to seroconvert after initial 0.1 mL administration produced high antibody titers thought to constitute a booster effect.

Increased levels of cytokines and high-mobility group box 1 are associated with the development of severe pneumonia, but not acute encephalopathy, in 2009 H1N1 influenza-infected children.

BACKGROUND: The 2009 A(H1N1) influenza virus has caused a large outbreak, and resulted in major complications of severe pneumonia and acute encephalopathy in the pediatric population in Japan. METHODS: This study examined six patients with acute encephalopathy, 34 patients with severe pneumonia, five patients with both pneumonia and encephalopathy, and 46 patients without severe complications. The concentrations of 27 cytokines were examined in the cerebrospinal fluid of patients with encephalopathy, and the levels of these cytokines, Cytochrome c, high-mobility group box 1 (HMGB1) were measured in the serum of all patients. RESULTS: Patients with severe pneumonia had higher serum concentrations of 16 cytokines, including Th1 cytokines, Th2 cytokines, chemokines, and growth factors, than patients with uncomplicated influenza. The distribution of 27 cytokines in the CSF did not parallel the serum levels in 11 patients with acute encephalopathy. HMGB1 concentrations in the serum were significantly higher in pneumonia patients with or without encephalopathy than in uncomplicated influenza patients, and were significantly associated with the upregulation of 10 cytokines. CONCLUSIONS: Elevated levels of Th2 cytokines appear to be unique to influenza caused by 2009 H1N1 influenza virus and HMGB1 could play an important role in the pathogenesis of severe pneumonia. There appear to be different pathologic processes for encephalopathy and pneumonia.

[Phases 3 and 4 immunization immunogenicity with combined measles-rubella vaccine].

A two-phase combined measles-rubella vaccine (MR) immunization schedule was introduced for age 1 and prior to primary school entry in Japan in April 2006. Further immunization was also introduced for 13 (Phase 3) and 18-year-old (Phase 4) cohorts for the 5-year period from April 2008 to March 2013. We surveyed Phases 3 and 4 MR immunization immunogenicity and safety. From August 2007 to December 2009, we conducted 3 Phase 3 and 15 Phase 4 immunizations. We then took paired serum samples (pre- and 4-6 weeks post-immunization), and measured measles antibody titers using hemagglutination inhibition (HI) and neutralizing test (NT), and rubella antibody titers using HI. Pre-positive measles HI antibody titer (> or = 8) was 72% (13/18) and pre-positive measles NT antibody titer (> or = 2) was 100% (18/18). Post-positive measles HI and NT antibody titers were 94% (17/18) and 100% (18/18). Mean post-immunization measles HI and NT antibody titers were significantly higher than pre-titers, with four-fold or greater increases seen in 9 (50%) and 6 (33%) subjects. Pre-positive rubella HI antibody titer (> or = 8) was 94% (17/18), and post-positive rubella HI antibody titer 100% (18/18). Mean post-immunization rubella HI antibody titer was significantly higher than pre-titer, with four-fold or greater increases seen in 8 subjects (44%). Paired HI antibody titers were measured in pre- and post-Phase 1 immunization for measles in 3 subjects and for rubella in 2 subjects. Those with post-Phase 1 measles HI antibody titers of 32, 64, and 128 yielded titers of 16, 8, and < 8 pre-Phase 3 or Phase 4 immunization, showing antibody reduction or seronegative conversion. Those with post-Phase 1 rubella HI antibody titers of 128 and 256 yielded titers of 64 and 32 in pre-Phase 4 immunization, showing antibody reduction. Seroconversion or four-fold or greater increases in titer were seen post-immunization in 60% (3/5) of these subjects. A clinical reaction survey of all subjects 4 weeks post-immunization, showed only 1 case of mild fever and no local or systemic adverse reactions such as generalized urticaria or anaphylaxis. In conclusion, Phases 3 and 4 MR immunogenicity was satisfactory.

[Varicella vaccine potency and stability during transport and delivery].

Oka varicella vaccine was developed to confer active immunity to varicella-zoster virus (VZV) in immunocompromized and immunocompetent children. It is now used to prevent varicella in about 20 million people worldwide. Although VZV infectivion is relatively unstable compared to other viruses, cell-free virus is stabilized and lyophilized vaccine has been developed. Virus titers were evaluated in vaccine distributed to six clinics in 5 years. Yearly mean virus titers at the vaccine producer were 42,000-67,000 plaque-forming units per dose, corresponding to Oka varicella vaccine (Zostavax) used to prevent zoster and postherpetic neuralgia by Oxman et al. Virus titer was found to be stable during delivery to clinics. Virus titers of varicella vaccine were equivalent to Zostavax and vaccine delivered to clinics had enough virus titer to confer active immunity to VZV in this study.

An Investigation of Japanese Neonatal and Maternal Antibody Status against Pertussis.

To clarify the pertussis immune status of the Japanese population, we investigated levels of serum pertussis toxin (PT)-specific immunoglobulin G (IgG) antibody in infants and mothers between April 2016 and March 2018. A total of 206 infants (n = 22, < 32 weeks of gestational age [wGA]; n = 70, 32-36 wGA; n = 114, ≥ 37 wGA) and 170 mothers were enrolled. The maternal seroprevalence and antibody geometric mean titer (GMT) were 52.4% and 10.7 EU/mL, respectively. The antibody GMT, seroprevalence, and mean ratio of infant to maternal antibody titers of infants at < 32 wGA were 3.2 EU/mL, 13.6%, and 42.5%, respectively, and were significantly lower than those of infants at 32-36 wGA (9.7 EU/mL, 54.3%, and 110.2%) and infants at ≥ 37 wGA (12.1 EU/mL, 57.9%, and 112.6%). Of the 21 infants who underwent a second examination, five were positive in the first examination. Of those five, the GMT for PT had decreased by an average of 52.6% at 4.3- week intervals. In the second examination, two infants were seropositive. Approximately half of the mothers and infants were negative for anti-PT antibody. Thus, new vaccination strategies, such as the vaccination of pregnant women, are needed to prevent pertussis infection in early infancy.

Community-acquired Acinetobacter baumannii meningitis in a previously healthy 14-month-old boy.

We report a previously healthy 14-month-old boy who developed community-acquired Acinetobacter baumannii meningitis. He had no history of immunodeficiency, and was brought to Konan Kosei Hospital with a high fever and vomiting. His consciousness was clear, but neck stiffness was noted. Examination of the cerebrospinal fluid (CSF) revealed a cell count of 10 112/microl; protein, 216 mg/dl; and glucose, 9 mg/dl. A CSF test kit for bacterial capsular antigens (Pastorex Meningitis; Bio-Rad Laboratories) was positive for Haemophilus influenzae type b antigen. On day 3 of admission, the microorganism isolated by CSF culture was identified as A. baumannii. Therefore, his treatment was changed to meropenem hydrate from the initial therapy with panipenem/betamipron and ceftriaxone sodium hydrate. Because the CSF cell count remained elevated, meropenem hydrate was administered for a total of 19 days. The meningitis resolved with no sequelae.