Common Bacterial Isolates And In Hospital Treatment Outcome Of Acute Bacterial Meningitis Among Children Suspected With Central Nervous System Infections Admitted At Dodoma Regional Referral

ABSTRACT

Background: Bacterial meningitis, is an inflammation of the meninges affecting the pia, arachnoid, and subarachnoid space that happens in response to bacteria and bacterial products invasion. The incidence of ABM has decreased significantly in developed countries especially after the addition of the Hib and pneumococcal conjugate vaccines to the routine childhood immunization schedule, but in most developing countries little is known on how the introduction of these vaccines has changed the incidence of ABM especially due to the existence of other comorbidities such as HIV and malnutrition. Objectives: Determination of prevalence, bacterial isolates and their antimicrobial resistant pattern, and in hospital treatment outcome of acute bacterial meningitis among children aged 2 months and 15 years who are suspected to have CNS infection admitted at DRRH. Methods: The study included a sample size of 101 patients aged 2 months to 15 years with features of CNS infection. The CSF obtained from these patients was analyzed by using culture, gram stain and latex agglutination test for identifying the etiological organism of ABM. MRDT, BS and CRAG to all HIV patients to rule out other causes of CNS infection. Results: The prevalence of ABM was found to be 4 %( 4/101). 1 species of E. coli and 3 species of S. pneumoniae were the main organism isolated. Severe acute malnutrution was found to be one of the major risk factors with a (OR5.3, 95%CI[2.005-5.924] p -value 0.04) while being immunized at least once against the common causative organisms was found to be protective against ABM with a p value vi of 0.04 ( OR0.04,95CI[ 0.02-0.9] p value 0.04). This disease was among the risks factors for requirement of physiotherapy at the time of discharge with (OR2.36 95CI [1.18- 19.7] p value 0.047) Conclusion: Despite wide spread of vaccination coverage, ABM is still prevalent with a local prevalence at Dodoma RRH of 4%. Children with Severe acute malnutrition were found to be at high risk for this ABM. Streptococcus pneumoniae which were the main isolates, had a resistance of about 50% to the first line antibiotics used for ABM. At discharge, children confirmed to have ABM were more likely to have neurological deficits requiring physiotherapy. Hence more efforts should be placed on diagnosis and identification of etiological organisms by using high sensitive techniques so as to improve treatment and outcome among patients with ABM