Typhoid fever in children: clinical presentation and risk factors

Abstract

The causative agents of acute bacterial meningitis vary from time to time and from place to place. In addition, changes in pathogen’s sensitivity to antibiotics in use occur. The study was undertaken to identify the pattern and susceptibility of pathogens to antibiotics among children beyond neonatal period for prompt empirical treatment of this important cause of morbidity and mortality especially in developing countries. Objective. To identify the pattern and susceptibility of pathogens in acute bacterial meningitis among children aged one month to 12 years at ABUTH Shika, Zaria. Method: This was a prospective study carried out in children presenting to Emergency Pediatric Unit of ABUTH Shika, Zaria, from October 1 st 2005 to September 30th, 2006. Children who met the inclusion criteria for lumbar puncture were consecutively recruited. Cerebrospinal fluid (CSF) samples were collected for microscopy, culture, sensitivity, and Latex Particle Agglutination (LPA) test. Sixty-six (66) patients satisfied the criteria for acute bacterial meningitis and were studied. Results: The prevalence of acute bacterial meningitis in this study was 6.9%. Sixty-six patients with acute bacterial meningitis were identified using 3 diagnostic methods (Gram stain, culture and LPA). The 3 commonest organisms were Streptococcus pneumoniae 34 (51.5%), Haemophilus influenzae 18 (27.3%), and Neisseria meningitidis 12 (11.2%). The sensitivity of the isolates to three commonly used noncephalosporin antibiotics was chloramphenicol 74.4%, penicillin 38.5%, and ampicillin 2.6%. The sensitivity to the cephalosporin was cefotaxime 97.4%, and ceftriaxone 89.7% while that to Ofloxacin, a quinolone, was 100%. Conclusion: The three commonest bacterial agents causing post neonatal meningitis were Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. There is an increasing resistance to the three commonly used nonc e p h a l o s p o r i n a n t i b i o t i c s (chloramphenicol, ampicillin and penicillin) and hence, cefotaxime or ceftriaxone should be used in the empirical treatment of children with suspected acute bacterial meningitis beyond neonatal period