Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

Abstract

AbstractsBackgroundMeningitis is an important cause of morbidity and mortality in low-resource settings. In sub-Saharan Africa, the meningitis belt has been characterized by particularly high and seasonal incidences of bacterial meningitis extending throughout life. Despite the progress being made in treating the condition, the mortality rates continue to be high, ranging between 2% and 30% globally. In Ghana, the mortality rate of meningitis has been estimated to range from 36% to 50%. However little information is available on the pathogens contributing to meningitis and their antimicrobial susceptibilities. Updated information is essential to adjust the recommendations for empirical treatment or prevention of meningitis which could have immense implications for local and global health.MethodsWe retrospectively reviewed laboratory records of all patients suspected of bacterial meningitis who underwent a lumbar puncture from January 1, 2008 to December 31, 2010. Data were retrieved from laboratory record books and double entered into a Microsoft® excel spreadsheet.ResultsRecords of 4,955 cerebrospinal fluid samples were analysed. Of these, 163 (3.3%, 95%CI: 2.8% to 3.8%) were confirmed meningitis and 106 (2.1%, 95%CI: 1.7% to 2.6%) were probable meningitis cases. Confirmed meningitis cases were made up of 117 (71.8%) culture positive bacteria, 19 (11.7%) culture positive Cryptococcus neoformans and 27(16.6%) Gram positive bacteria with negative culture. The most prevalent bacteria was Streptococcus pneumoniae 91 (77.7%), followed by E.coli 4 (3.4%), Salmonella species 4 (3.4%), Neisseria meningitidis 3 (2.5%), Pseudomonas species 3(2.5%) and others. Pneumococcal isolates susceptibility to penicillin, chloramphenicol and ceftriaxone were 98.9% (95%CI: 94.0% to 100.0%), 83.0% (95%CI: 73.4% to 90.1%) and 100.0% (95%CI: 95.8% to 100.0%) respectively.ConclusionStreptococcus pneumoniae is an important cause of meningitis among all age groups and its susceptibility to penicillin and ceftriaxone still remains very high. Ghanaians of all ages and possibly other developing countries in the meningitis belt could benefit from the use of the pneumococcal vaccine. Other bacterial and fungal pathogens should also be considered in the management of patients presenting with meningitis.

Salmonella Meningitis: a Report from National Hue Central Hospital, Vietnam

“…Salmonella infection as a cause of bacterial meningitis is reported primarily in tropical areas (1,2), but also occasionally in industrialized countries (3)(4)(5). Most cases of Salmonella meningitis involve children less than 1 year of age, primarily less than 3 months old (3,4).…”

Spectrum of Meningitis in Adult at the Douala General Hospital

“…This difference could be explained by their relatively small sample of 70 patients studied; of which 40 had a bacteriological diagnosis due to the inability of the patients to pay for this test. Pneumococcus is reported as the most frequent causal agent of adult meningitis with proportions varying from 45.2% to 77.7% [5]- [7] [9] [12]. However, two african studies have reported the Pneumococcus as the second most frequent aetiologic agent of bacterial meningitis with proportion of 37.1% in a Tunisian study coming after Haemophilus influenzae [13] and 4.8% coming after Meningococcus in Mozambique [14].…”

Streptococcus salivarius Meningitis in Immunocompetent: A Case Report

“…The usual CSF findings are white blood cell count of 1000 to 5000/ µL with the percentage of neutrophils usually greater than 80%, protein > 200 mg/dL, and glucose < 40 mg/ dL. However, there have been reports shown in multiple studies where bacterial meningitis has no CSF abnormalities [8,9].…”