Etiology and outcome of culture proven bacterial meningitis in children 6 to 24 months of age.

Abstract

Introduction: Pediatric bacterial meningitis is a life-threatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. More than 2/3 cases of meningitis occur in the 1^st 2 years of life, owing to decreased immunity and high vascularity of the brain.This study was conducted to determine the frequency of hemophilus influenzae type b, streptococcus pneumonia and neisseria meningitidis and outcome in culture proven meningitis in children 6 months to 24 months. Study Design: Case series. Setting: Paeds Unit 1, Bahawal Victoria Hospital, Bahawalpur and Paeds Unit of District Headquarter (DHQ) Teaching Hospital, Dera Ghazi Khan. Period: 1^st April 2017 to 30^th September 2018. Material and Methods: A total of 220 children (110 from each center) of either sex with culture proven meningitis, aged 6 months to 24 months, were included in the study. Demographics, duration of fever, history of seizures, weight of child, vaccination status and bacteria isolated from CSF and outcome were analyzed. The outcome in the form of mortality was noted during the first 10 days of hospital stay. Results: Amongst a total of 220 children, 123 (55.9%) were male. There were 130 (59.1%) children who were less than or equal to 1 year of age. There were 154 (70.0%) children who were having a weight of 7 to 10 kg. Vaccination status was, 111 (50.5%) were fully vaccinated, 59 (26.8%) partially vaccinated and 50 (22.7%) not vaccinated. Duration of fever was, 141 (64.1%) had fever for more than 5 days. There were 139 (63.2%) children who had a history of seizures.  Streptococcus pneumonia was the commonest bacteria found in 110 (50%) children followed by neisseria meningitides 53 (24.1%), H. Influenza 37 (16.8%). Overall mortality was noted in 34 (15.5%) children. Conclusion: In children with bacterial meningitis, mortality was high and most common bacteria were found to be s.pneumoniae followed by neisseria meningitidis and h.influenzae. Awareness about the empiric and directed antimicrobial therapy will help to lower the burden of morbidity and mortality related to bacterial meningitis.