Epidemiological study of bacterial meningitis in Tunisian children, beyond neonatal age, using molecular methods: 2014-2017

Haddad-Boubaker, Sondès; Lakhal, Marwa; Fathallah, Cyrine; Mhimdi, Samar; Bouafsoun, A.; Kechrid, A.; Smaoui, H.

doi:10.4314/ahs.v20i3.14

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…11 And Haddad-Boubaker et al reported that the most common bacterial meningitis agents were pneumococcus (69.84%), followed by meningococcus (28.57%) and Hib (1.59%), respectively, in Tunisian children between 2014 and 2017. 12 N. meningitidis was found to be the most common among bacterial agents in line with previous studies in our country conducted by Ceyhan et al 13 We think that this data available in our country is the result of routine vaccination against Hib and S. pneumoniae , although N. meningitidis is not in the routine immunization program. H. influenzae type b was not detected in our patients and only two cases of S. pneumoniae meningitis was found.…”

Section: Discussionsupporting

confidence: 90%

Investigation of the Etiological Causes of Central Nervous System Infection in Children with Multiplex PCR

Karaaslan

Çetin

Köle

et al. 2022

J Pediatr Infect Dis

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Objective The aim of this study is to investigate the causative agents of central nervous system (CNS) infection in hospitalized pediatric patients by multiplex polymerase chain reaction. Methods We retrospectively reviewed the medical records of children who underwent lumbar puncture with suspected CNS infection between September 2019 and September 2021. The cerebrospinal fluid (CSF) samples were evaluated by the BioFire FilmArray Meningitis/Encephalitis (ME) Panel. Results The etiology of the infection was established in 13,02% (n = 25) cases. Human herpesvirus (HHV) type 6 was the most commonly identified pathogen 60% (n = 15), followed by enterovirus 20% (n = 5), Streptococcus pneumoniae 8% (n = 2), Streptococcus agalactiae 4% (n = 1), HHV type 1 4% (n = 1), and Listeria monocytogenes 4% (n = 1). The statistical analysis showed that the age of the group with enterovirus was younger than the age of the group with other causative microorganisms and the group with HHV-6 (respectively p: 0.032; p: 0.011). The hospitalization periods of the group with enterovirus and HHV-6 were shorter than the hospitalization periods of the other causative microorganisms (respectively p: 0.016; p: 0.000) and the absolute neutrophil count values of the group with HHV-6 were lower than the group of other causative microorganisms (p: 0.015). Conclusion Our study identified HHV-6 as the main cause of CNS infection in Istanbul during coronavirus disease 2019 pandemic when isolation measures were taken. The duration of hospital stay was found to be shorter in CNS infection caused by viral agents. Revealing the causative agent in the CSF is a fast and effective method that prevents unnecessary antibiotic treatment and shortens the hospitalization period of patients.

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Section: Discussionsupporting

confidence: 90%

Investigation of the Etiological Causes of Central Nervous System Infection in Children with Multiplex PCR

Karaaslan

Çetin

Köle

et al. 2022

J Pediatr Infect Dis

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“…In this study, bacterial co-infection cases due to Streptococcus pneumoniae and Haemophilus influenzae were the most prevalent and complicated. Noticeably, this study was achieved prior to the introduction of pneumococcal vaccine in April 2019 in Tunisia [35]. This vaccine is believed to substantially reduce the burden of pneumococcal disease.…”

Section: Discussionmentioning

confidence: 99%

High genotypic diversity of Rhinoviruses obtained from Tunisian children with severe acute respiratory infection

Haddad-Boubaker

Mefteh

Mejri

et al. 2021

J Infect Dev Ctries

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Introduction: Rhinoviruses (HRV) are among the leading causes of Severe Acute Respiratory Infection (SARI). Their burden and genetic diversity vary from one region to another and little is known in Northern African regions. This study describes epidemiological patterns and genotypic diversity of HRV in SARI cases during a two and half year’s study, in Northern Tunisia. Methodology: A total of 271 SARI cases, admitted into the Pediatric Intensive Care Unit of Bechir Hamza Children's Hospital in Tunis, were collected between September 2015 and December 2017. The investigation concerned 104 samples positive for HRV and/or HEV (Human Enterovirus) obtained among these cases. Specific HRV and HEV detections were assessed by real-time PCRs. The HRV molecular typing was based on the VP4-VP2 genomic region analyses. Results: Among the viral SARI cases, 33.5% and 12.3% were positive for HRV and HEV respectively. Molecular investigations showed high prevalence of HRV-A (63.3%) followed by HRV-C (30.6%) and HRV-B (6.1%) and high genotypic diversity with 27 types. HRV cases were mostly detected in toddlers younger than 6 months. A total of 16 cases (28%) were found with bacterial and/or viral co-infection. HRV-C infection and HRV-A with bacterial co-infection were associated with complicated infection. Some of the detected types showed a continuous circulation or turnover during an extended period. HRV-A101 and HRV-C45 were the most frequently detected types. Conclusions: This study revealed, for the first time, the high HRV diversity in Tunisia, a North-African region. Specific phylogenetic investigations may help to evaluate their diversity and to trace their spread and epidemiological origin.

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“…There were more studies available on serogroup distribution from the EM region versus the NA region. Data were available from Iran (n = 2) [ 67 , 68 ], Kuwait (n = 1) [ 51 ], Qatar (n = 1) [ 69 ], Saudi Arabia (n = 6) [ 54 – 56 , 70 – 72 ], and Turkey (n = 8) [ 57 – 59 , 73 – 77 ], in the EM region (spanning 1987–2018), and from Egypt (n = 3) [ 61 , 78 , 79 ], Morocco (n = 6) [ 80 – 85 ], and Tunisia (n = 6) [ 64 , 86 – 90 ], in the NA region (spanning 1977–2019). Serogroups A, B and W were most frequently reported in the EM region, while B and C serogroups were most frequently reported in the NA region.…”

Section: Objective 2: Imd Epidemiologymentioning

confidence: 99%

Systematic review of invasive meningococcal disease epidemiology in the Eastern Mediterranean and North Africa region

Dogu

Oordt-Speets²,

Bruijn³

et al. 2021

BMC Infect Dis

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Background Invasive meningococcal disease (IMD) represents a global health burden. However, its epidemiology in the Eastern Mediterranean (EM) and North Africa (NA) regions is currently not well understood. This review had four key objectives: to describe asymptomatic meningococcal carriage, IMD epidemiology (e.g. serogroup prevalence, case-fatality rates [CFRs]), IMD presentation and management (e.g. clinical diagnosis, antibiotic treatments) and economic impact and evaluation (including health technology assessment [HTA] recommendations) in EM and NA. Methods A systematic literature search (MEDLINE and EMBASE) was conducted (January 2000 to February 2021). Search strings included meningococcal disease and the regions/countries of interest. Identified publications were screened sequentially by title/abstract, followed by screening of the full-text article; articles were also assessed on methodological quality. Literature reviews, genetic sequencing or diagnostic accuracy studies, or other non-pertinent publication type were excluded. An additional grey literature search (non-peer-reviewed sources; start date January 2000) was conducted to the end of April 2019. Results Of the 1745 publications identified, 79 were eligible for the final analysis (n = 61 for EM and n = 19 for NA; one study was relevant to both). Asymptomatic meningococcal carriage rates were 0–33% in risk groups (e.g. military personnel, pilgrims) in EM (no data in NA). In terms of epidemiology, serogroups A, B and W were most prevalent in EM compared with serogroups B and C in NA. IMD incidence was 0–20.5/100,000 in EM and 0.1–3.75/100,000 in NA (reported by 7/15 countries in EM and 3/5 countries in NA). CFRs were heterogenous across the EM, ranging from 0 to 57.9%, but were generally lower than 50%. Limited NA data showed a CFR of 0–50%. Data were also limited in terms of IMD presentation and management, particularly relating to clinical diagnosis/antibiotic treatment. No economic evaluation or HTA studies were found. Conclusions High-risk groups remain a significant reservoir of asymptomatic meningococcal carriage. It is probable that inadequacies in national surveillance systems have contributed to the gaps identified. There is consequently a pressing need to improve national surveillance systems in order to estimate the true burden of IMD and guide appropriate prevention and control programmes in these regions.

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Epidemiological study of bacterial meningitis in Tunisian children, beyond neonatal age, using molecular methods: 2014-2017

Cited by 10 publications

References 32 publications

Investigation of the Etiological Causes of Central Nervous System Infection in Children with Multiplex PCR

Investigation of the Etiological Causes of Central Nervous System Infection in Children with Multiplex PCR

High genotypic diversity of Rhinoviruses obtained from Tunisian children with severe acute respiratory infection

Systematic review of invasive meningococcal disease epidemiology in the Eastern Mediterranean and North Africa region

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