Hacettepe University Faculty of Medicine, Turkey
Kubra Aykac has graduated as a pediartician in 2012 and has been practising as a fellow in the Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey. She is interested in pneumococcal disease and multi-drug resistant gram-negative bacterial diseases
Statement of the Problem: Bacterial meningitis is a serious infection that can cause death within hours as well as neurological sequelae in patients. The majority of the causative agents are Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae type b. In recent years, meningitis epidemiology showed a rapid change due to vaccination. We aimed to invastigate the etiologic agents of bacterial meningitis in the present study.
Findings: Between January 2012 and January 2017, a total of 157 cerebrospinal fluid samples were studied in the study and 45 were evaluated as contamination. The median age of 112 patients diagnosed with acute bacterial meningitis was 1 year (minimum-maximum, 0-17) and the rate of female/ male was 48/64. The etiologic agents were 42 (37.5%) staphylococcus, 16 pneumococci (14.2%), 9 (8.9%) meningococci, 7 (6.2%) enterococci, 7 (4.4%) Acinetobacter spp, 7 (4.4%) E. coli, 4 (3.5%) Klebsiella spp. CSF shunt was presented in 53.6% of the patients and staphylococci was the most common causative agent (53.3%) in this population. According to the underlying diseases, there were totally 80 (71.4 %) patients with neurogical disease and %46.2 of them had staphylococcal meningitidis. In two patients with immunodeficiency, one of the causative agent was staphylococci and the other was multiple agents. Pneumococci (33.3%) and meningococci (28.6%) were the most frequent factors in children without no underlying disease. Serotypes could be detected in only four of 16 patients with pneumococcal meningitis. Two of them were nonvaccine serotype (15B) and others were serotype 19F and 1. The serogroups of nine patients with meningococcal meningitis were three serotype W , two serotype B, and and four nongroupable.o
Conclusion & Significance: Due to the high frequency of pneumococcal and meningococcal meningitis cases, our findings indicates the importance of vaccination against these pathogens. The frequency of shunt meningitis also suggests that shunt infections should be managed effectively.