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Bacterial meningitis in Saudi Arabia: the impact of Haemophilus influenzae type b vaccination

M Almuneef1, M Alshaalan, Z Memish

  • 1Department of Pediatrics, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.

Journal of Chemotherapy (Florence, Italy)
|July 4, 2001
PubMed

Insights

Haemophilus influenzae type b (Hib) was the most common cause of bacterial meningitis in children under two years old. Mass vaccination with the Hib conjugate vaccine significantly reduced its incidence, improving outcomes and reducing mortality.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Vaccinology

Background:

  • Bacterial meningitis is a significant cause of childhood morbidity and mortality.
  • Understanding causative agents and their trends is crucial for public health interventions.

Purpose of the Study:

  • To review culture-proven bacterial meningitis cases in children at King Fahad National Guard Hospital (KFNGH).
  • To determine the most common pathogens, clinical presentations, and outcomes.
  • To assess the impact of Haemophilus influenzae type b (Hib) conjugate vaccine introduction.

Main Methods:

  • Retrospective chart review of 67 culture-proven bacterial meningitis cases in children.
  • Analysis of patient demographics, causative organisms, clinical symptoms, treatment outcomes, and antimicrobial resistance.

Main Results:

  • Bacterial meningitis predominantly affected children under 2 years (85%).
  • Haemophilus influenzae type b (Hib) was the most frequent pathogen (57%), followed by Streptococcus pneumoniae (31%).
  • Hib incidence decreased dramatically post-vaccination; Hib meningitis had better outcomes (85%) than S. pneumoniae (53%).
  • 43% of S. pneumoniae isolates showed penicillin resistance; no cephalosporin resistance was observed.
  • Overall mortality was 6% (4 deaths), primarily from S. pneumoniae.

Conclusions:

  • Hib conjugate vaccine introduction significantly reduced Hib meningitis incidence and improved outcomes.
  • Streptococcus pneumoniae remains a significant cause of pediatric meningitis with concerning penicillin resistance.
  • Mandatory Hib vaccination for all Saudi children is recommended due to its high prevalence and impact.

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