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[Haemophilus influenzae meningitis. Review of 21 cases]
Abstract:
Twenty-one cases of "Haemophilus influenzae" meningitis occurred over a seven year period. An ampicillin-resistant strain was isolated in three (14,2%), but the percentage of ampicillin-resistant strains rose to 33% over the last two years, in meningitis and to 38% in all patients whose blood or CSF grew "Haemophilus influenzae". One case (4,7%) had severe neurologic damage, and 3 (14%) had minor damage. The estimated duration of symptoms prior to proper treatment correlated with duration of fever conscience depression, and hospital stay. Both of the patients with symptoms prior to treatment lasting over 72 hours had sequellae. Chloramphenicol should be included in the therapy of every patient suspected of having severe "Haemophilus influenzae" infection in our region.
Insights
Ampicillin-resistant Haemophilus influenzae meningitis is increasing, with 38% resistance noted. Early treatment is crucial, as delayed care over 72 hours led to sequelae in patients.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Haemophilus influenzae meningitis poses a significant public health challenge.
- Emergence of antibiotic resistance in H. influenzae complicates treatment strategies.
Purpose of the Study:
- To analyze trends in ampicillin resistance of H. influenzae causing meningitis.
- To evaluate the impact of treatment delay on patient outcomes.
- To recommend optimal therapeutic approaches for H. influenzae meningitis.
Main Methods:
- Retrospective analysis of 21 H. influenzae meningitis cases over seven years.
- Monitoring of ampicillin resistance rates in H. influenzae isolates from blood and cerebrospinal fluid (CSF).
- Correlation of symptom duration before treatment with clinical outcomes and hospital stay.
Main Results:
- Ampicillin resistance in H. influenzae meningitis rose to 33% in the last two years.
- Overall resistance in blood or CSF isolates reached 38%.
- Delayed treatment (over 72 hours) was associated with severe neurologic damage and prolonged hospital stays, with both patients experiencing sequelae.
Conclusions:
- Chloramphenicol should be considered in empirical therapy for severe H. influenzae infections in this region due to rising ampicillin resistance.
- Prompt diagnosis and treatment initiation are critical to prevent neurological damage and improve patient prognosis.
- Continued surveillance of antibiotic resistance patterns is essential for effective H. influenzae meningitis management.