ETIOLOGY AND NEUROLOGICAL COMPLICATIONS OF BACTERIAL MENINGITIS IN 189 PATIENTS

Abstract

Results of a seven year (April 1985 to March 1992) prospoective study of bacterial meningitis in 189 infants and children admitted to our Center indicate that: 1) Tiie Gram-negative bacilli, especially Klebsiella species, are the leading cause of bacterial meningitis in neonates and young infants (<2 months), group B Streptococcus meningitis is rare, and Listeria monocytogenes meningitis is not observed. 2) Haemophilus influenzae is the leading cause of bacterial meningitis in children under 4 years old and Streptococcus pneumoniae becomes the leading cause over 5 years old. 3) Nine percent of H. influenzae isolates were ampicillin - resistant and 5% of S. pneumoniae were penicillin G resistant. All but one Niesseria meningitidis isolates were penicillin - susceptible. Both penicillin G f chloramphenicol or ampicillin/chloramphenicol resistance among these isolates were 2 percent. 4) The neurological compilations and mortality were highest under two months of age, 39% of these neonates died due to complications as compared to 22% in all other age groups combined. 5) Dexamethasone improves outcome when used as an adjunctive therapy for bacterial meningitis in infants and children. Tlie immediate and long-term clinical profiles both indicate better outcomes for dexamethasone.

Keywords

• etiological agents
• empirical therapy
• neurological complications