Acute bacterial meningitis among children admitted into an Iranian referral children's hospital

Abstract

Bacterial meningitis is a serious threat to global health, particularly in developing countries. The aim of this study was to determine the etiological agents of acute bacterial meningitis, its clinical features, and antibacterial susceptibility among Iranian children who were admitted to a referral regional children's hospital. Laboratory data as well as symptoms and signs on admission, organism identification and antibiotic susceptibility results, physical examination findings, and neurologic features of 31 patients with suspected invasive bacterial infection were evaluated, of which 20 (64.5%) had positive cerebrospinal fluid (CSF) cultures. The microorganisms most commonly associated with bacterial meningitis in children were Streptococcus pneumoniae (7 isolates, 22.5%), Haemophilus influenzae (3 isolates, 10%), and Neisseria meningitidis (3 isolates, 10%). In our study, the rate of mortality and sequelae were 10% and 35%, respectively. Ventriculomegaly hydrocephalus was found in 1 case positive for Mycobacterium tuberculosis meningitis, while other signs of meningitis were negative. According to our results, abnormalities including brain edema, subdural effusion, microabscess, and ventriculomegaly hydrocephalus were observed in 50% of the patients with confirmed bacterial meningitis; therefore, identification of predictors of early neurological complications is highly recommended. In addition, CSF culture using the BACTEC automated system is recommended for detection of the etiologic agents of bacterial meningitis, particularly in a population like ours, in which the patients receive a course of antibiotics without prescription.