Related Experiment Videos
Pyogenic meningitis in Ibadan, Nigeria. A 15-month prospective study
Abstract:
Between January 1976 and March 1977, cerebrospinal fluid samples from 2130 patients at University College Hospital, Ibadan, Nigeria were examined, 130 patients were shown to have pyogenic meningitis. The commonest causative bacteria were Streptococcus pneumoniae (53.8%), Haemophilus influenzae (23%), Neisseria meningitidis (7.7%) and Klebsiella spp. (3%). Most of the infections occurred in very young children: 47% of all patients were under 1 year of age, and 69% were under 5 years old. The overall case fatality rate was 30% (Strep. penumoniae infection 28.6%, H. influenzae and N. meningitidis infection both 20%). All 4 patients with klebsiella infection died. There was a noticeable increase in the incidence of Strep. pneumoniae strains showing resistance to tetracycline, between 1974 and 1976, and this was attributed to the widespread use and abuse of the antibiotic among the general population. Two strains of H. influenzae were found to be resistant to ampicillin; such strains have not previously been reported from Nigeria. The results of the study support the use of a combination of ampicillin and gentamicin in the initial treatment of pyogenic meningitis in Ibadan.
Insights
Pyogenic meningitis in Nigerian children is most often caused by Streptococcus pneumoniae and Haemophilus influenzae. Early ampicillin and gentamicin treatment is recommended due to rising antibiotic resistance.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Pyogenic meningitis poses a significant threat, particularly to young children.
- Understanding causative agents and antibiotic resistance patterns is crucial for effective treatment.
- Previous data on pyogenic meningitis in Ibadan, Nigeria, is limited.
Purpose of the Study:
- To identify the common bacterial causes of pyogenic meningitis in Ibadan, Nigeria.
- To determine the age distribution and case fatality rates of pyogenic meningitis.
- To assess antibiotic resistance patterns of causative bacteria and inform treatment guidelines.
Main Methods:
- Cerebrospinal fluid samples from 2130 patients were analyzed between January 1976 and March 1977.
- Bacterial identification and susceptibility testing were performed.
- Patient demographics and outcomes were recorded.
Main Results:
- 130 cases of pyogenic meningitis were diagnosed.
- Streptococcus pneumoniae (53.8%) and Haemophilus influenzae (23%) were the most frequent pathogens.
- Infections predominantly affected children under five years old (69%), with a 30% overall case fatality rate.
- Increasing tetracycline resistance in S. pneumoniae and emerging ampicillin resistance in H. influenzae were observed.
- Klebsiella spp. infections had a 100% mortality rate.
Conclusions:
- Pyogenic meningitis in Ibadan is a severe disease primarily affecting young children.
- Emerging antibiotic resistance necessitates careful treatment selection.
- A combination of ampicillin and gentamicin is recommended for initial empirical treatment.