Clinical analysis on 129 hospitalized children with purulent bacterial meningitis

Objective: The present study aimed to explore etiology, clinical features and treatment of children with purulent bacterial meningitis. Methodology: Hospital based retrospective cross sectional study, we reviewed cases of purulent bacterial meningitis occurring at Qilu hospital from January 2011 through September 2016. Records of all patients, comprising data on clinical presentations, laboratory findings and treatment were obtained and analyzed. Results: 129 children met criteria and were analyzed. Male to female ratio was 1.8:1, 82(63.6%) males and 47(36.4%) female. Cases were classified into five age groups: 1month-1 year76%, 1-2 years 4.7%, 2-5 years 8.5%, 5-12 years 8.5% and 12-15 years 2.3% (mean age is 2.93 months). Confirmed cases were 48(37%), the main bacteria cultured were Staphylococcal species 21%, Streptococcus pneumoniae 19%, group B Streptococcus (GBS) 15% and Escherichia coli 13%. Less detected bacteria were Enterococcus fecalis, Enterococcus fecium and Klebsiella pneumoniae. Staphylococcal species showed resistance to penicillin G by 100%, Oxacillin 62%, Amoxicillin 50%, Ampicillin sulbactam 38% and Ceftriaxone 38%. Gram positive bacterial were sensitive to vancomycin, chloramphenicol, Meropenem and linezolid whereas Gram negative bacteria were sensitive to Meropenem, amikacin and linezolid. Conclusion: Staphylococcal species, Streptococcal pneumoniae, Group B streptococcal and Escherichia coli were the predominant pathogens responsible for purulent bacterial meningitis over the past 5¾ years. Rate of bacteria detection is still low and emergence of antimicrobial resistance together are of great concern, Therefore more intervention are needed to be address so as to reduce burden of Purulent bacterial meningitis and its neurological sequalae to the survivors.