Acute Bacterial Meningitis in Adults: a Hospital Based Study in Yemen

Abdulrab, Amin; Algobaty, Faker; Salem, Ahmed Kaid; Mohammed, Y Alnami

doi:10.7883/yoken.63.128

Cited by 15 publications

(7 citation statements)

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“…In the present study, S. aureus also showed a high level of drug resistance against amoxicillin (100%), penicillin G. (100%), ciprofloxacin (100%), and erythromycin (100%). Comparable findings were reported from Gondar Ethiopia [18] and Iran [21].…”

Section: Discussionsupporting

confidence: 81%

“…Bacterial antimicrobial resistance is a worldwide problem particularly, in developing countries like Ethiopia, the situation is serious [17]. Despite advancements in antimicrobial therapy, and vaccine availability the mortality remains high, in developing countries among adults [18] and children [19]. However, increasing the frequency of reports of bacterial resistance in vitro to the commonly used drugs has raised a concern that this choice of management may not be longer appropriate [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial sensitivity profile and bacterial isolates among suspected pyogenic meningitis patients attending at Hawassa University Hospital: Cross-sectional study

et al. 2020

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Background Bacterial meningitis is a serious inflammation of the meninges. Antimicrobial therapy on early cerebrospinal fluid (CSF) examination has an important role in diagnosis. The disease is still challenging in developing countries because of poor (diagnostic set-up, socioeconomic conditions, management), and misuse of antimicrobial therapy results in emerging antimicrobial-resistant strains. Therefore, this hospital based cross sectional study was aimed to assess the antimicrobial sensitivity profile and bacterial isolates among patients suspected of pyogenic meningitis at Hawassa University Hospital from February 2017 to 2018. Results A total of 394 patients suspected as meningitis were included. Of these 210 (53.3%) were males and 184 (46.7%) were females. The carriage rate of bacterial pathogens was 27(6.9%). The common clinical presentations were fever 330 (83.8%), headache 205 (52.0%) and neck stiffness 179(45.4%) followed by altered mental status 125(31.7%). Neck stiffness P = 0.001 (AOR = 1.18, 95% CI 1.06–6.53), Hx of seizure P = 0.043, (AOR = 1.39, 95% CI 1.15–5.99), Nuchal rigidity P = 0.001* (AOR = 1.26, 95% CI 1.06–4.48) were significantly associated with culture positivity. The pathogens isolated in this study were N. meningitidis the most frequent isolate 12(44.4%) followed by S. pneumoniae 5 (18.5%), E. coli 4(14.8%), H. influenza 3(13.6%), S. aureus 2(11.1%) and K. pneumoniae 1(3.7%). S. pneumoniae was (100%) resistance to penicillin, (80%) amoxicillin, and (20%) Cefotaxime. S. aureus was (100%) resistant to penicillin, amoxicillin, and ciprofloxacin. N. meningitidis was (100%) resistant to penicillin, (66.7%) Ceftriaxone and (41.7%) chloramphenicol. In this study a single isolate was also resistant to a different antibiotic. Conclusion The prevention of bacterial meningitis needs serious attention since the isolated bacteria showed single and multiple antimicrobial susceptibility patterns and the variable nature of isolated etiological agents makes it reasonable to provide continuous future updates on local resistance of common antibiotics and optimize the most frequent bacteria associated with meningitis in the hospital. Therefore; further, survey study with a better design of antimicrobial susceptibility at large scale to control the spread of antibiotic-resistant bacteria and the change in the causative organism of bacterial meningitis in the study area and at a national level is required.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Antimicrobial sensitivity profile and bacterial isolates among suspected pyogenic meningitis patients attending at Hawassa University Hospital: Cross-sectional study

et al. 2020

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“…We retrieved 371 studies with 427 study periods performed from January 1, 1935, to December 31, 2019, in 108 countries, describing 157 656 episodes of community-acquired bacterial meningitis …”

Section: Resultsmentioning

confidence: 99%

“…The design was observational in 330 studies (94%) and interventional in 20 (6%) studies, with 12 to 22 831 (median [IQR], 115 [61-270]) episodes per study, and the inclusion period’s length varying from 3 months to 36 years (median [IQR], 5 [2-10] years). Studies included neonates (59 studies [16%]; 6549 episodes [4%]), children (101 studies [27%]; 21 511 episodes [14%]), adults (64 studies [17%]; 15 362 episodes [10%]), neonates and children (68 studies [18%]; 26 992 episodes [17%]),…”

Section: Resultsmentioning

confidence: 99%

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

van Ettekoven,

Liechti,

Brouwer

et al. 2024

JAMA Netw Open

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ImportanceThe impact of vaccination, antibiotics, and anti-inflammatory treatment on pathogen distribution and outcome of bacterial meningitis over the past century is uncertain.ObjectiveTo describe worldwide pathogen distribution and case fatality ratios of community-acquired bacterial meningitis.Data SourcesGoogle Scholar and MEDLINE were searched in January 2022 using the search terms bacterial meningitis and mortality.Study SelectionIncluded studies reported at least 10 patients with bacterial meningitis and survival status. Studies that selected participants by a specific risk factor, had a mean observation period before 1940, or had more than 10% of patients with health care–associated meningitis, tuberculous meningitis, or missing outcome were excluded.Data Extraction and SynthesisData were extracted by 1 author and verified by a second author. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Random-effects models stratified by age (ie, neonates, children, adults), Human Development Index (ie, low-income or high-income countries), and decade and meta-regression using the study period’s year as an estimator variable were used.Main Outcome and MeasureCase fatality ratios of bacterial meningitis.ResultsThis review included 371 studies performed in 108 countries from January 1, 1935, to December 31, 2019, describing 157 656 episodes. Of the 33 295 episodes for which the patients’ sex was reported, 13 452 (40%) occurred in females. Causative pathogens were reported in 104 598 episodes with Neisseria meningitidis in 26 344 (25%) episodes, Streptococcus pneumoniae in 26 035 (25%) episodes, Haemophilus influenzae in 22 722 (22%), other bacteria in 19 161 (18%) episodes, and unidentified pathogen in 10 336 (10%) episodes. The overall case fatality ratio was 18% (95% CI, 16%-19%), decreasing from 32% (95% CI, 24%-40%) before 1961 to 15% (95% CI, 12%-19%) after 2010. It was highest in meningitis caused by Listeria monocytogenes at 27% (95% CI, 24%-31%) and pneumococci at 24% (95% CI, 22%-26%), compared with meningitis caused by meningococci at 9% (95% CI, 8%-10%) or H influenzae at 11% (95% CI, 10%-13%). Meta-regression showed decreasing case fatality ratios overall and stratified by S pneumoniae, Escherichia coli, or Streptococcus agalactiae (P &lt; .001).Conclusions and RelevanceIn this meta-analysis with meta-regression, declining case fatality ratios of community-acquired bacterial meningitis throughout the last century were observed, but a high burden of disease remained.

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“…This descriptive cross-sectional study was conducted among children admitted with acute ME (viral and bacterial) to Al-Wahda Teaching Hospital in Aden over the period from January to June 2010. Children were included if they met the following criteria: (11,12) aged between 1 month and 14 years, with at least three suggestive clinical features of acute ME of the following manifestations: fever, seizures, vomiting, alteration of consciousness and neck stiffness, with cerebrospinal fluid (CSF) findings indicative of bacterial or viral infection and whose mothers/guardians agreed to give informed consent to participate voluntarily in the study. On the other hand, children were excluded if they were diagnosed on clinical suspicion without performing a lumbar puncture (LP), they had a traumatic LP or left the hospital before data collection, or their CSF was not analyzed.…”

Section: Study Design Setting and Populationmentioning

confidence: 99%

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

Bawazeer¹

2019

Yemeni J Med Sci

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Objective: To determine the types and frequencies of complications associated with acute meningoencephalitis (ME) among children admitted to hospitals in Aden, Yemen. Methods: This descriptive cross-sectional study was conducted among 60 children (1 month – 14 years of age) admitted to AL-Wahda Teaching Hospital in Aden with acute ME (viral or bacterial) over the period from January to June 2010. Data were collected using a pre-designed questionnaire, and data were presented as frequencies and percentages and analyzed using appropriate statistical tests. Differences or associations between categorical variables were considered statistically significant at P values <0.05. Results: ME complications were significantly higher among children aged less than one year compared to those aged one year or older (58.8% vs. 38.5%, respectively) and among those with bacterial ME compared to those with viral ME (79.2% vs. 30.6%, respectively). The complications were also significantly higher among children with history of illness for three or more days before their admission compared to those having been ill for less than three days (65.8 vs. 22.7%, respectively). In addition, children aged less than two years not exclusively breastfed were more prone to ME complications compared to those exclusively breastfed (93.5% vs. 50.0%, respectively). Increased intracranial pressure (ICP), anemia and hypoglycemia were the three most frequent ME complications among children admitted to Al-Wahda Teaching Hospital, being observed in 53.3%, 50.0% and 43.3% of patients, respectively. Increased ICP was significantly higher among children aged five years or older compared to those aged less than five years (88.9% vs. 47.1%, respectively). In contrast, anemia and hyperglycemia were significantly higher among children aged less than five years (56.9% and 49.0%, respectively) compared to those aged five years or older (11.1% each). Conclusions: ME complications are significantly higher among children aged less than one year, infected with bacterial ME, with history of illness for three or more days before their admission and not exclusively breastfed. Increased ICP, anemia and hypoglycemia are the three most frequent ME complications, particularly among children with bacterial ME in Aden, followed by focal neurological deficits seizures and cranial nerve palsy. Although increased ICP is significantly higher among children aged five years or older, anemia and hyperglycemia are significantly higher among children aged less than five years. Active measures to promote immunization and exclusive breastfeeding along with early diagnosis and proper treatment are highly recommended. Further large-scale studies are required to study the pattern of complications following acute ME among Yemeni children. Keywords: Meningoencephalitis, Complication, Intracranial pressure, Seizure, Focal neurological sign, Cranial nerve palsy, Yemen.

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Acute Bacterial Meningitis in Adults: a Hospital Based Study in Yemen

Cited by 15 publications

References 15 publications

Antimicrobial sensitivity profile and bacterial isolates among suspected pyogenic meningitis patients attending at Hawassa University Hospital: Cross-sectional study

Antimicrobial sensitivity profile and bacterial isolates among suspected pyogenic meningitis patients attending at Hawassa University Hospital: Cross-sectional study

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

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