Childhood Acute Bacterial Meningitis: Clinical Spectrum, Bacteriological Profile and Outcome.
OBJECTIVE
To determine the disease pattern, etiological agents and outcome of childhood acute bacterial meningitis.


METHODS
Adescriptive study.


METHODS
Department of Paediatric Medicine, The Children's Hospital, Lahore, from January to December 2012.


METHODS
Atotal of 199 children between the ages of 1 month and 5 years, admitted with the diagnosis of meningitis on the basis of clinical findings and positive cerebrospinal fluid (CSF), were included. In all patients, complete blood count (CBC), CSF culture sensitivity, and blood culture sensitivity were performed. Data was analysed using SPSS version 20.


RESULTS
Out of 199 children, 127 (63.8%) were males with M:F ratio of 1.7:1. Mean age was 11.33 ±12 months. Maximum numbers of children were < 1 year of age, 136 (68.3%). Only 90 (45.2%) children were fully vaccinated according to Expanded Program of Immunisation (EPI) schedule. Presentations with refusal to take feed (p=0.008) and with impaired conscious state were independent predictors of death (p=0.002). Complications were noted in 34 (17%) and were significantly associated with severe malnutrition (p=0.006) and altered conscious level at presentation (p < 0.001). The common pathogens identified on CSF culture were coagulase negative staphylococci (CoNS) in 11 (5.5%) and streptococcus pneumoniaein 5 (2.5%). Overall mortality was 10.1%. The commonest pathogen isolated from children who died was streptococcus pneumoniae(p=0.039).


CONCLUSIONS
Acute bacterial meningitis mostly affected children under the age of 1 year. CSF culture revealed both Grampositive and Gram-negative bacteria. The most common pathogen in children who died was streptococcus pneumoniae.
Department of Paediatric Medicine, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
Attia
A
Bari
Department of Paediatric Medicine, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
Fatima
F
Zeeshan
Department of Microbiology, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
Aiza
A
Zafar
Department of Microbiology, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
Hassan
H
Ejaz
Department of Paediatric Medicine, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
Aisha
A
Iftikhar
Department of Paediatric Medicine, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
Ahsan Waheed
AW
Rathore
D000208:Acute Disease / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid / Q000382:microbiology* / Q000401:mortality*; D010154:Pakistan / Q000453:epidemiology; D011008:Pneumococcal Infections / Q000150:complications / Q000473:pathology; D011446:Prospective Studies; D013210:Staphylococcus / Q000302:isolation & purification*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*