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Childhood bacterial meningitis in Al-Baha province, Saudi Arabia
N A al-Jurayyan1, A S al Mazyad, M N al-Nasser
1Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Bacterial meningitis in Saudi Arabian children predominantly affects males under two years old. Haemophilus influenzae type B (HIB) and Streptococcus pneumoniae are the most common pathogens, with Group B-beta haemolytic streptococcus causing the highest mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Bacterial meningitis is a significant cause of childhood morbidity and mortality globally.
- Understanding local epidemiological patterns and causative pathogens is crucial for effective prevention and treatment strategies.
Purpose of the Study:
- To review the epidemiological characteristics and etiological agents of bacterial meningitis in pediatric patients in Al-Baha, Saudi Arabia.
- To assess treatment outcomes and identify antibiotic resistance patterns.
Main Methods:
- Retrospective review of 71 pediatric patients diagnosed with bacterial meningitis.
- Analysis of cerebrospinal fluid (CSF) isolates and patient demographics.
- Evaluation of mortality rates and antibiotic susceptibility.
Main Results:
- The study identified a male preponderance (67.6%) and a high incidence in children under 24 months (88.7%).
- Common pathogens included Haemophilus influenzae type B (47.3%), Streptococcus pneumoniae (34.5%), and Group B-beta haemolytic streptococcus (9.1%).
- Mortality was highest in Group B-beta haemolytic streptococcal meningitis (40%), while Neisseria meningitidis was uncommon.
Conclusions:
- Haemophilus influenzae type B and Streptococcus pneumoniae are the primary bacterial meningitis pathogens in this Saudi Arabian pediatric cohort.
- Emphasis on vaccination, particularly conjugate vaccines for HIB, is essential for prevention.
- Monitoring antibiotic resistance is critical for guiding therapeutic interventions.
Abstract:
A retrospective review of 71 paediatric patients admitted with bacterial meningitis to the King Fahad Hospital at Al-Baha, Saudi Arabia, during an 8-year period revealed a preponderance of males (67.6%) and young subjects with 88.7% being below 24 months of age. The commonest cerebrospinal fluid pathogens in the series were Haemophilus influenzae type B (HIB), Streptococcus pneumoniae and Group B-beta haemolytic streptococcus, which were responsible for 47.3, 34.5 and 9.1% of cases respectively. Neisseria meningitidis which is a major cause of meningitis in most other reports was uncommon in the present series, and was isolated from only two patients. All the children with Group B-beta haemolytic streptococcal meningitis were below 3 months of age while 96.2% of the children with HIB meningitis were younger than 2 years. Mortality was highest (40%) among the infants with Group B-beta haemolytic streptococcal meningitis. Six (23.1%) of the HIB isolated were resistant to ampicillin and two (7.7%) were resistant to both ampicillin and chloramphenicol. There is a need for greater emphasis on prevention through the use of available vaccines including the newly introduced conjugate vaccines against HIB which are capable of eliciting immune responses in infants as young as 2 months.