Etiologies of Bacterial Meningitis in Bangladesh: Results from a Hospital-Based Study

Abstract

We conducted a study at four hospitals from June 2003 to July 2005 to investigate the etiologies of bacterial meningitis in Bangladesh. A total of 2,609 patients met the clinical case definition, and 766 had cerebrospinal fluid tested by at least one of the following methods: latex agglutination, 16S rRNA gene sequencing, or real-time polymerase chain reaction for Neisseria meningitidis A and C, Streptococcus pneumoniae, and Haemophilus influenzae type b (Hib); culture results were noted from patient records. In total, 189 patients (24%) of those tested, representing all age groups, were diagnosed with bacterial meningitis; 136 (18%) had meningococcal, 23 (3%) had pneumococcal, and 25 (3%) had Hib infection. Twenty percent of patients with Hib meningitis (5/25) were > 15 years old. Case-fatality ratios were 10% for N. meningitidis, 22% for S. pneumoniae, and 24% for Hib. Bacterial meningitis from vaccine-preventable pathogens causes significant morbidity and mortality in Bangladesh in adults and children.

Investigation of Bacterial Meningitis Agents from Patients with Suspicion of Non-Neonatal Meningitis by Conventional and Molecular Methods

“…Çalışmamızda, bakteriyel menenjit tanısı alan hastaların en sık semptomu literatürle (17,18) uyumlu olarak ateş, ardından ise meninks irritasyon bulguları ve baş ağrısı olarak bulundu.…”

“…Bakteriyel menenjitlerde BOS lökosit sayısı çeşitli çalışmalarda, 906-9455/mm 3 arasında bildirilmiş (3,16,17,19) , Gurley ve ark. (17) ise bu löko-sitlerin %80'ini PNL olarak bildirmişlerdir.…”

“…(17) ise bu löko-sitlerin %80'ini PNL olarak bildirmişlerdir. Çalışmamızda, hastalarımızın BOS lökosit sayı-larının ortalaması 2169/mm 3 , lökosit tipi değer-lendirmesinde ise %89.5'inin PNL ağırlıklı lökositlerden oluştuğunu belirlendi.…”

Neutrophilic bacterial meningitis: pathology and etiologic diagnosis of fatal cases

“…However, mortality reported for patients with bacterial meningitis ranges between 9 and 35% depending on the bacterium causing the meningitis, the prevalence of the different pathogens in particular populations, having a diagnosis, and the healthcare that can be provided to the patients. [4][5][6][7][8][9] Worldwide, Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus agalactiae, Escherichia coli, and Listeria monocytogenes are the most frequent etiologic agents of community-acquired bacterial meningitis. [4][5][6][7][8][9] Staphylococcus aureus is the most frequent pathogen in patients that have undergone intracranial surgery.…”

“…[4][5][6][7][8][9] Worldwide, Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus agalactiae, Escherichia coli, and Listeria monocytogenes are the most frequent etiologic agents of community-acquired bacterial meningitis. [4][5][6][7][8][9] Staphylococcus aureus is the most frequent pathogen in patients that have undergone intracranial surgery. 6 Surveillance data based on cultures from eight areas participating in the US Emerging Infections Programs Network in the 1998-2007 period showed that S. pneumoniae caused meninigitis in 58% of cases and accounted for 71% of the fatalities.…”