BACTERIAL ETHIOLOGY OF ACUTE CHILDHOOD MENINGITIS IN SHIRAZ-IRAN: INCIDENCE CLINICAL PICTURES, COMPLICATIONS AND ANTIBIOTIC SENSITIVITY PATTERN

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ALBORZI A.; VAHEDI F.; KARIMI A.; AZMOODEH M.; LABAF R.; KADIVAR M.R.; ABOODI B.

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Journal: Iranian Journal of Infectious Diseases and Tropical Medicine Year:2002 | Volume:7 | Issue:18 Page(s): 26-31

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BACTERIAL ETHIOLOGY OF ACUTE CHILDHOOD MENINGITIS IN SHIRAZ-IRAN: INCIDENCE CLINICAL PICTURES, COMPLICATIONS AND ANTIBIOTIC SENSITIVITY PATTERN

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Abstract

Acute bacterial meningitis (ABM) is a disease mostly affected young children. Etiology of bacterial meningitis varies in the world. In Iran etiology and epidemiology of bacterial meningitis specially caused by Haemophilue influenzae type b (Hib) has not been documented. The epidemiological feature and etiology of (ABM) is extremetly important for management of patients especially in countries where vaccination is not given for bacteria such as Hib. This study was designed to determine the bacterial etiology of childhood meningitis and also to determine if Hib vaccination is necessary to be put in the list of vaccination program. Ten hundred and sixty two CSF specimens were collected prospectively from a group of patients of 2 months-12 years of age who were under investigation for suspected bacterial meningitis at University affiliated and other city hospitals between May 1999-May 2000. Major clinical data was obtained from the patient at the entry of admission. All the laboratory works including measurement of CSF protein and sugar levels, total and differential cell count, Gram's and acridine orange staining, latex agglutination test, bacterial culture and antibiotic susceptibility test (Le. disc diffusion method) were performed in Professor Alborzi Clinical Microbiology Research Center (PACMRC) at Namazi Hospital. For isolated pneumococci penicillin sensitivity test was determined by Minimum Inhibitory Concentration (MIC) method. Based on clinical and laboratory data of the 1062 patients who were underwent lumbar puncture (LP) viral meningitis were identified in 260 cases. Definitive diagnosis of bacterial meningitis was recognized in 67 patients. Despite of clinical diagnosis of 31 patients with bacterial meningitis they were not proved by laboratory tests. One questionable case of TB meningitis was also diagnosed. The etiological agents of 67 proved cases of bacterial meningitis were Hib (24 cases), pneumococci (23 cases), meningococci (17 cases), salmonella (one case), pseudomonas (one case) and citrobacter (one case) respectively. The annual incidence rate of bacterial meningitis among 100,000 children between 2 months-12 years of age for Hib, meningococci and pneumococci were 6.5, 3.4 and 1.5 respectively. However, the male: female ratio of total number of proved and suspicious cases of bacterial meningitis was 2:1. The pattern of antibiotic susceptibility test (Le. resistance) for 11 isolated pneumococci was as follows: 3 cases (27%) highly resistant to penicillin, 7 cases (64%) intermediate resistant to penicillin and one case (9%) intermediate resistant to ceftriaxone, cefotaxime and chloramphenicol respectively. The pattern of antibiotic susceptibility test (Le. resistance) for 16 isolated Hib was as follows: 8 cases (50%) highly resistant to ampicillin, 4 cases (25%) intermediate resistant to ampicillin. Furthermore, there were 3 cases of Hib resistanct to cefotaxime (18.7%), 2 cases of Hib resistant to ceftriaxone (12.5%) and 7 cases of Hib resistant to chloramphenicol (43.7%) respectively. Hib and pneumococci are the most common causes of bacterial meningitis among the children in this region (P< 0.01). This study determined that incidence of bacterial meningitis especially caused by Hib among the children in Iran is less common than other parts of the world (prior to vaccination). The resistance of pneumococci and Hib to penicillins in this part of country is higher, compared to the developed countries.

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APA: Copy

ALBORZI, A., VAHEDI, F., KARIMI, A., AZMOODEH, M., LABAF, R., KADIVAR, M.R., & ABOODI, B.. (2002). BACTERIAL ETHIOLOGY OF ACUTE CHILDHOOD MENINGITIS IN SHIRAZ-IRAN: INCIDENCE CLINICAL PICTURES, COMPLICATIONS AND ANTIBIOTIC SENSITIVITY PATTERN. IRANIAN JOURNAL OF INFECTIOUS DISEASES AND TROPICAL MEDICINE, 7(18), 26-31. SID. https://sid.ir/paper/52993/en

Vancouver: Copy

ALBORZI A., VAHEDI F., KARIMI A., AZMOODEH M., LABAF R., KADIVAR M.R., ABOODI B.. BACTERIAL ETHIOLOGY OF ACUTE CHILDHOOD MENINGITIS IN SHIRAZ-IRAN: INCIDENCE CLINICAL PICTURES, COMPLICATIONS AND ANTIBIOTIC SENSITIVITY PATTERN. IRANIAN JOURNAL OF INFECTIOUS DISEASES AND TROPICAL MEDICINE[Internet]. 2002;7(18):26-31. Available from: https://sid.ir/paper/52993/en

IEEE: Copy

A. ALBORZI, F. VAHEDI, A. KARIMI, M. AZMOODEH, R. LABAF, M.R. KADIVAR, and B. ABOODI, “BACTERIAL ETHIOLOGY OF ACUTE CHILDHOOD MENINGITIS IN SHIRAZ-IRAN: INCIDENCE CLINICAL PICTURES, COMPLICATIONS AND ANTIBIOTIC SENSITIVITY PATTERN,” IRANIAN JOURNAL OF INFECTIOUS DISEASES AND TROPICAL MEDICINE, vol. 7, no. 18, pp. 26–31, 2002, [Online]. Available: https://sid.ir/paper/52993/en

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