Culture Proven Bacterial Meningitis in Children: Agents, Clinical Profile and Outcome

Abstract

Background Meningitis is a serious infection. Little is known about the bacterial agents and their antibacterial sensitivity in Nepalese children. Objectives To study bacteriological agents, clinical profile and immediate outcome in patients admitted to children’s ward of Patan Hospital with meningitis. Methods Prospective observational study conducted in paediatric ward of Patan Hospital. All the children admitted to the ward, with the diagnosis of culture proven bacterial meningitis’ on discharge were eligible. Results Out of 7,751 children, 296 (3.8%) had meningitis. This was a group ranging from neonates to adolescents aged 18 years. Only 13 (4.4%) of cerebrospinal fluid samples taken from them yielded positive culture reports. The organisms were pneumococcus (6), Haemophilus influenza ‘b’ (3), ?-hemolytic Streptococcus (1), ?-hemolytic Streptococcus (1), N. meningitides (1) and Pseudomonas (1). Whereas Haemophilus influenza ‘b’ was isolated from young infants, pneumococci were found in the young as well as the old. Fever, vomiting, high leukocyte count with left shift were all commonly present. All but one had cerebrospinal fluid pleocytosis. Low sugar and high protein was found in most specimens. Neuroimaging was done in six children of which three were abnormal (all young infants and pneumococci cases). Ceftriaxone was given to all but one child. Everybody recovered but three had complications – profound hearing loss and cortical atrophy with subdural collection in pneumococcal and septic arthritis with persistence of fever in Haemophilus influenzae ‘b’ meningitis. Conclusion The present study corroborates most of the epidemiological and clinical features of acute bacterial meningitis and sheds light on the causative agents of bacterial meningitis in Nepalese children. http://dx.doi.org/10.3126/kumj.v9i1.6260 Kathmandu Univ Med J 2011;9(1):36-40

Bacterial meningitis in children under 15 years of age in Nepal

“…Of the 252 CSF samples, only 18 (7.2 %) revealed significant growth in this study. In similar studies conducted in Nepal, significant growths of various isolates were also detected by Shah et al (3.7 %) in 2001 [ 25 ] and Ansari et al (4.4 %) in 2011 [ 26 ]. Proportionately, a high rate of bacterial growth (17.7 %) was detected by Wu et al in 2013 [ 27 ].…”

Predictors of Meningitis in Under-Fifteen Children Attending an Intensive Care Unit of an Urban Large Diarrheal Disease Hospital in Bangladesh

“…This phenomenon is common but may cause life threatening ramifications due to meningitis [17]. Our observed neutrophilia in peripheral blood is common and might be due to severe infection in this population which has also been observed previously [18,19]. We observed high case fatality rate among children with meningitis, which has been reported in a number of earlier studies [20,21].…”

Etiology of Meningitis from Patients Suspected of Meningitis Attending Tribhuvan University Teaching Hospital, Kathmandu, Nepal

“…According to Mahmoud and Abd-ElSadik (2013) the World Health Organization (WHO) indicates that each year registers nearly half a million new cases suffering from meningitis and WHO (2005) estimates that bacterial meningitis affects approximately 1.2 million people each year globally and causes almost 170,000 deaths worldwide each year. There is also paucity of objective data on the causative agents of meningitis and their susceptibility in Nepalese population (Ansari and Pokhrel, 2011). Due to the urgency associated with the treatment of meningitis, there is, therefore, the need to have knowledge of the causative agents and their susceptibility profiles to come to better decisions of the empirical treatment.…”