VACCINES OVER ANTIBIOTICS: SAUDI ARABIA'S JOURNEY OF MANAGING PEDIATRIC BACTERIAL MENINGITIS

Saudi Arabia had high rates of bacterial meningitis in the late 90s. Children are at highest risk of this devastating disease with poor outcomes.

The study aims to evaluate the prevalence, causative pathogens, and antibiotic resistance patterns in pediatric bacterial meningitis cases at a tertiary hospital in Riyadh, Saudi Arabia.

Single-center retrospective chart review and cross-sectional methodology was conducted at King Saud University Medical City (KSUMC) from 2015 to 2023.

Reviewing 8 years of CSF culture results only yielded 37 cases. This is only 0.5% of total hospital admissions over 8 years. The majority of cases were for children under the age of 2 years (82%). Gender of cases was almost equal and there was no seasonal variation. The most common organisms were gram-positive (14, 38%) including Group B streptococcus (GBS) (4, 11%), Streptococcus pneumoniae (4, 11%). Gram-negative organisms caused 8 cases (22%) by 5 different organisms. There was no Haemophilus influenza type B or meningococcus found in any of the CSF cultures. The single sample of Staphylococcus aureus was methicillin-resistant Staphylococcus aureus (MRSA) and three gram-negative organisms were multidrug resistant.

Saudi Arabia provides an example of the success of a mass vaccination program to curb the burden of pediatric bacterial meningitis. Future efforts should focus on antibiotic stewardship, mass screening of GBS, and adopting additional strains for the pneumococcus vaccine. Further research is needed to address the rising number of gram-negative organisms causing pediatric bacterial meningitis in Saudi Arabia and globally.