Armaghane Danesh Bimonthly Journal (Nov 2019)
Prevalence of Bacterial Causes of Meningitis and Related Factors in Patients Admitted to Imam Sajjad Hospital in Yasuj
Abstract
Background & aim: Bacterial meningitis is still recognized as one of the most dangerous infectious diseases that can lead to high mortality if not diagnosed and treated in a timely manner. The aim of this study was to determine the prevalence of bacterial agents causing meningitis and related factors in patients admitted to Imam Sajjad Hospital in Yasuj. Methods:The present study was a cross-sectional descriptive-analytical study. The statistical population consisted of 106 patients one month to 14 years old referred to Imam Sajjad Hospital in 2018 who were analyzed for cerebrospinal fluid after clinical suspicion of meningitis. Spinal fluid sample of patients with white blood cell count greater than 5 was diagnosed as bacterial meningitis and one cc of it was stored at -20 ° C. Samples were analyzed for Meningococcus, Hemophilus influenza, Streptococcus pneumoniae and genotypes of this species using MULTIPLEX REAL TIME-PCR method by Tag Man method. Demographic, clinical and laboratory data were also collected and recorded. Data were analyzed using descriptive statistics and chi-square test. Results: Of the total patients understudy, 33%(35) were female and 67%(71) were male. Most patients(50.9%) were between one month and one year of age. 34% (36 cases) of the specimens were confirmed as bacterial meningitis, 25 of which were pneumococcal and 11 of them were hemophilus influenzae type b. F19 genotype had the highest prevalence among pneumococcal genotypes. No positive results were found for meningococcus. Only one case of cerebrospinal fluid culture was positive, which was negative for coagulase staph. Also, only 8 cases(89.6%) had positive blood cultures. The most common clinical symptom was fever. There was a statistically significant difference between the negative PCR group and the positive PCR groups for vomiting (p=0.01), rash(p=0.03), Brodzinski(p=0.02) and underlying disease(p=0.002) and CSF(p=0/0009) existed. Conclusion: According to the results obtained in this study, it can be concluded that pneumococcal and Haemophilus influenzae type b bacteria main cause of meningitis in children in the study, in addition to the cultivation of CSF and blood cultures correlate very poorly with results from PCR.
