A Five-Year Retrospective Multicenter Study on Etiology and Antibiotic Resistance Pattern of Bacterial Meningitis Among Iranian Children

Bacterial meningitis is a devastating infection associated with significant morbidity and mortality rate among neonates and young children. Early identification and treatment of the causative agents of meningitis is crucial due to high fatality rate in untreated cases. The present study aimed to investigate the common bacterial etiology and occurrence of antimicrobial resistance in patients suspected to meningitis in southwestern Iran.

This retrospective cross-sectional study was conducted during a five-year period from January 2011 to January 2016 at two major hospitals in southwestern Iran. CSF samples were aseptically collected in BACTECTM, and conventional methods were used for the bacteria isolation and identification. Antimicrobial susceptibility tests were done using disk diffusion and E-test methods.

Out of 89 CSF samples collected from children under 17 years, the number of culture positive specimens was 21 (23.6%). The highest number of culture positive cases was observed in patients younger than 5 years (57.1 %). The most frequent pathogens were Streptococcus pneumonia (N = 10, 47.6%), followed by Haemophilus spp. (N = 3, 14.3%), and Neisseria meningitidis (N = 3, 14.3%). Antibacterial susceptibility testing results showed that S. pneumoniae isolates were mostly susceptible to vancomycin and chloramphenicol. Moreover, among N. meningitides and Haemophilus isolates, the most effective in vitro drug was ceftriaxone (100%).

These results showed the promising activity of several locally available antibiotics against S. pneumoniae, Haemophilus spp. and N. meningitides, as the most common causative agents of bacterial meningitis in Iranian children. Therefore, such regional studies help prevent and control the burden of infections.