Etiology and antimicrobial resistance patterns of acute bacterial meningitis in children : a 10-year referral hospital-based study in Northwest Iran

Abstract EN

Background : Bacterial meningitis is still considered as one of the most dangerous infectious diseases, which causes numerous complications and high mortality if not diagnosed and treated timely.

Objectives : This study was performed to determine antimicrobial resistance patterns of bacterial pathogens isolated from acute bacterial meningitis at Tabriz Children Educational-Health Care Center in Iran.

Patients and Methods : In a retrospective study (from 2003 through 2013), all patients with bacterial meningitis were identified by cerebrospinal fluids with positive results in culture (107 cases).

Patients' necessary data was recorded in a questionnaire.

Furthermore, the results of simultaneous blood culture were also examined.

Ultimately, antimicrobial susceptibility of isolates was determined using the disc diffusion method.

Results : One hundred and seven patients with bacterial meningitis were identified by cerebrospinal fluids with positive results in culture.

All of patients (100 %) had fever (male / female = 1.27 / 1).

The most prevalent pathogens isolated from CSF culture were Streptococcus pneumoniae (34.5 %), Haemophilus influenzae type b (23.36 %), Neisseria meningitidis (6.54 %), Serratia spp.

(6.54 %), and Klebsiella pneumoniae (5.6 %), respectively.

Moreover, the patients' blood culture had positive results in 36.44 % of cases with H.

influenzae type b (20.65 %) and S.

pneumoniae (6.54 %) as the main bacteria isolated from blood.

Meningitis occurred mostly in children under two years (P = 0.001).

According to antimicrobial susceptibility test, a relatively high resistance was reported against some conventional cephalosporins and other antibiotics.

Conclusions : S.

pneumoniae and H.

influenzae type b were the main pathogens of bacterial meningitis in children in the area under study.

Most species had relatively high resistance to conventional antibiotics as compared to the past.