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A review of bacteriological profile of acute pyogenic meningitis in a tertiary care center in Southwest Nigeria

Year 2019, Volume: 3 Issue: 7, 464 - 468, 29.07.2019
https://doi.org/10.28982/josam.524140

Abstract

Aim: Pyogenic meningitis remain a major cause of mortality and morbidity in lower middle income countries. There exists a wide variability in antibiogram profile of infective causes of acute pyogenic meningitis seeking for individualized management protocol. This study aim to review a five years profile of isolates from suspected cases and evaluate the antibiogram of the infective agent in a tertiary hospital in South west Nigeria.

Methods: All patients presenting to the hospital with signs and symptoms suggestive of meningitis were evaluated. Aside random plasma glucose, CSF samples were sent for biochemistry, gene expert for tuberculosis and cultured on Blood agar, Chocolate agar and MacConkey agar for neonates and read after 24hours incubation.  

Results: 393 of the 657,890 patients seen in the hospital over a five year period suspected to have meningitis were investigated, 22(7%) had a positive culture. Streptococcus pneumoniae (31.8%), Haemophilus influenzae (27.4%), other Enterobacteriaceae (18.2%), Pseudomonas aeruginosa (9.1%), Staphylococcus aureus (4.5%), Proteus mirabilis (4.5%) and Candida albicans (4.5%) were isolated. 

Conclusion: Spectrum of causative bacterial agent is not different from documented in other parts of the country. Streptococcus pneumoniae predominance was reported which is sensitive to Ampicillin, Ceftriaxone, Cefotaxime and Penicillin. Empirical treatment with Ceftriaxone or Cefotaxime can be instituted while awaiting laboratory confirmation in suspected cases.

References

  • 1. Allan RT, Diederik BW, Michael S. Acute Meningitis. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Churchill Livingston Elsevier. 2010;1189.
  • 2. Micheal AA. Neisseria menigitidis. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Churchill Livingston Elsevier.2010; p. 2737-2752.
  • 3. Terrie T. Emergency Plan of Action (EPoA) Nigeria: Meningitis. International Federation of Red Cross and Red Crescent Societies.2017. https:// www.adore.ifrc.org/Download.aspx?FileId=161742. Last Access date: 29 November 2018
  • 4. Allan RT, Diederik BW, Michael S. Acute Meningitis. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Churchill Livingston Elsevier.2010; pg 1208
  • 5. Ashraf ES, Salma MA, Mikhail NM. Diagnosis of Major Bacterial Causes of Culture Negative meningitis in Children. Egypt J Med Microbiol. 2014;23:47-57.
  • 6. Syamal M, Amit KA. Phenotypic Characterization And Antibiogram Of CSF Isolates In Acute Bacterial Meningitis. J Clin Diagn Res. 2013;12:2704–8.
  • 7. Mohammad ZA. Prevalence and rapid diagnosis of acute bacterial meningitis in children in Bangladesh.2018. https://www.omicsonline.org/proceedings/prevalence-and-rapid-diagnosis-of-acute-bacterial-meningitis-in-children-in-bangladesh-100459.html. Last acces date: 26 June 2019
  • 8. Remmy A. Meningitis: List Of States Affected By Deadly Disease In Nigeria, 2017. https://www.nigerianbulletin.com/threads/meningitis-list-of-states-affected-by-deadly-disease-in-nigeria.236534. Last access date: 01 May 2019
  • 9. FMOH. Nigeria: Meningitis Outbreak. 2017. https://reliefweb.int/disaster/ep-2017-000030-nga. Last access date: 26 June 2019
  • 10. Lawal B. Federal Government of Nigeria and Partners Ramp up response to Meningitis C Outbreak.2017. https://reliefweb.int/report/nigeria/federal-government-nigeria-and-partners-ramp-response-meningitis-c-outbreak. Last access date 5 April 2019
  • 11. Thomas V, Riaz A and Qasim S. Cerebro Spinal Fluid Analysis in Childhood Bacterial Meningitis. Oman Med J. 2008;23:32–33.
  • 12. Kenneth CI and Abdullahi N. Profiles of acute bacterial meningitis isolates in children in National Hospital, Abuja. Niger Med J. 2015;56:297–300.
  • 13. Alausa OK, Onile BA. The pattern of bacterial meningitis in Ibadan (A 21-month prospective study) Niger Med J. 1984;14:167–70
  • 14. Akpede GO, Adeyemi O, Abba AA, Sykes RM. Pattern and antibiotic susceptibility of bacteria in pyogenic meningitis in a children's emergency room population in Maiduguri, Nigeria, 1988-1992. Acta Paediatr. 1994;83:719–23.
  • 15. Fagbule D, Joiner KT. Pattern of childhood mortality at the University of Ilorin teaching hospital. Niger J Paediatr. 1987;4:1–5.
  • 16. Ojinaka NC, Iloeje SO. Neurological complications of childhood bacterial meninigitis as seen in Enugu. Niger J Paediatr. 1998;25:53–6.
  • 17. Akpede OI, Abiodun PO, Sykes M, Salami CE. Childhood bacterial meningitis beyond the neonatal period in southern Nigeria: changes in organisms/antibiotic susceptibility. East Afr Med J. 1994;71:14-20.
  • 18. Johnson WB, Adedoyin OT, Abdulkarim AA, Olanrewaju WI.Bacterial pathogens and outcome determinants of childhood pyogenic meningitis in Ilorin, Nigeria. Afr J Med Med Sci. 2001;30:295-303.
  • 19. Lagunju IA, Falade AG, Akinbami FO, Adegbola R, Bakare RA.Childhood bacterial meningitis in Ibadan, Nigeria--antibiotic sensitivity pattern of pathogens, prognostic indices and outcome. Afr J Med Med Sci. 2008;37:185-91.
  • 20. World Health Organization. Epidemic and pandemic alert and response. Standardized treatment of bacterial meningitis in Africa in epidemic and non epidemic situations. 2007. www.who.int/csr/resources/publications. Last access date: 4 April 2019
  • 21. Sanya E, Taiwo S, Azeez O, Oluyombo R. Bacteria Meningitis: Problems Of Empirical Treatment In A Teaching Hospital In The Tropics. J Infect Dis. 2006;6:1.
  • 22. Ozumba UC. Acute bacterial meningitis in Enugu, Nigeria. 1 April 1989 to 31 March 1993. Cent Afr J Med. 1995;41:54-9.
  • 23. Ogunlesi TA, Okeniyi JA, Oyelami OA. Pyogenic meningitis in Ilesa, Nigeria. Indian Pediatr. 2005;42:1019-23.

Güneybatı Nijerya'da bir üçüncü basamak merkezde akut piyojenik menenjitin bakteriyolojik profilinin gözden geçirilmesi

Year 2019, Volume: 3 Issue: 7, 464 - 468, 29.07.2019
https://doi.org/10.28982/josam.524140

Abstract

Amaç: Piyojenik menenjit, düşük orta gelirli ülkelerde önemli bir mortalite ve morbidite nedenidir. Bireyselleştirilmiş yönetim protokolü arayan akut piyojenik menenjitin enfektif nedenlerinin antibiyogram profilinde geniş bir değişkenlik vardır. Bu çalışmada, şüpheli vakalardaki izolatların beş yıllık bir profili gözden geçirilerek Güney Batı Nijerya'daki bir üçüncü basamak hastanede enfektif ajanın antibiyogramının değerlendirilmesi amaçlanmıştır.

Yöntem: Menenjit düşündüren belirti ve bulguları olan hastaneye başvuran tüm hastalar değerlendirildi. Rastgele plazma glukozunun yanı sıra, CSF örnekleri biyokimya, tüberküloz için gen uzmanı olarak gönderildi ve yenidoğanlar için Blood agar, Chocolate agar ve MacConkey agar üzerinde kültürlendi ve 24 saat inkübasyondan sonra okundu.

Bulgular: Hastanede menenjit geçirdiğinden şüphelenilen beş yıllık bir süre içinde görülen 657.890 hastanın 393'ü araştırıldı, 22'sinde (%7) pozitif kültür vardı. Streptococcus pneumoniae (%31,8), Haemophilus influenzae (%27,4), diğer Enterobacteriaceae (%18,2), Pseudomonas aeruginosa (%9,1), Staphylococcus aureus (%4,5), Proteus mirabilis (%4,5) ve Candida albicans (%4,5).

Sonuç: Nedensel bakteri ajanının spektrumu, ülkenin diğer bölgelerinde belgelenenlerden farklı değildir. Ampisilin, Ceftriaxone, Cefotaxime ve Penicillin'e duyarlı Streptococcus pneumoniae baskınlığı bildirilmiştir. Şüpheli vakalarda laboratuvar onayı beklenirken Ceftriaxone veya Cefotaxime ile ampirik tedavi uygulanabilir.

References

  • 1. Allan RT, Diederik BW, Michael S. Acute Meningitis. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Churchill Livingston Elsevier. 2010;1189.
  • 2. Micheal AA. Neisseria menigitidis. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Churchill Livingston Elsevier.2010; p. 2737-2752.
  • 3. Terrie T. Emergency Plan of Action (EPoA) Nigeria: Meningitis. International Federation of Red Cross and Red Crescent Societies.2017. https:// www.adore.ifrc.org/Download.aspx?FileId=161742. Last Access date: 29 November 2018
  • 4. Allan RT, Diederik BW, Michael S. Acute Meningitis. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Churchill Livingston Elsevier.2010; pg 1208
  • 5. Ashraf ES, Salma MA, Mikhail NM. Diagnosis of Major Bacterial Causes of Culture Negative meningitis in Children. Egypt J Med Microbiol. 2014;23:47-57.
  • 6. Syamal M, Amit KA. Phenotypic Characterization And Antibiogram Of CSF Isolates In Acute Bacterial Meningitis. J Clin Diagn Res. 2013;12:2704–8.
  • 7. Mohammad ZA. Prevalence and rapid diagnosis of acute bacterial meningitis in children in Bangladesh.2018. https://www.omicsonline.org/proceedings/prevalence-and-rapid-diagnosis-of-acute-bacterial-meningitis-in-children-in-bangladesh-100459.html. Last acces date: 26 June 2019
  • 8. Remmy A. Meningitis: List Of States Affected By Deadly Disease In Nigeria, 2017. https://www.nigerianbulletin.com/threads/meningitis-list-of-states-affected-by-deadly-disease-in-nigeria.236534. Last access date: 01 May 2019
  • 9. FMOH. Nigeria: Meningitis Outbreak. 2017. https://reliefweb.int/disaster/ep-2017-000030-nga. Last access date: 26 June 2019
  • 10. Lawal B. Federal Government of Nigeria and Partners Ramp up response to Meningitis C Outbreak.2017. https://reliefweb.int/report/nigeria/federal-government-nigeria-and-partners-ramp-response-meningitis-c-outbreak. Last access date 5 April 2019
  • 11. Thomas V, Riaz A and Qasim S. Cerebro Spinal Fluid Analysis in Childhood Bacterial Meningitis. Oman Med J. 2008;23:32–33.
  • 12. Kenneth CI and Abdullahi N. Profiles of acute bacterial meningitis isolates in children in National Hospital, Abuja. Niger Med J. 2015;56:297–300.
  • 13. Alausa OK, Onile BA. The pattern of bacterial meningitis in Ibadan (A 21-month prospective study) Niger Med J. 1984;14:167–70
  • 14. Akpede GO, Adeyemi O, Abba AA, Sykes RM. Pattern and antibiotic susceptibility of bacteria in pyogenic meningitis in a children's emergency room population in Maiduguri, Nigeria, 1988-1992. Acta Paediatr. 1994;83:719–23.
  • 15. Fagbule D, Joiner KT. Pattern of childhood mortality at the University of Ilorin teaching hospital. Niger J Paediatr. 1987;4:1–5.
  • 16. Ojinaka NC, Iloeje SO. Neurological complications of childhood bacterial meninigitis as seen in Enugu. Niger J Paediatr. 1998;25:53–6.
  • 17. Akpede OI, Abiodun PO, Sykes M, Salami CE. Childhood bacterial meningitis beyond the neonatal period in southern Nigeria: changes in organisms/antibiotic susceptibility. East Afr Med J. 1994;71:14-20.
  • 18. Johnson WB, Adedoyin OT, Abdulkarim AA, Olanrewaju WI.Bacterial pathogens and outcome determinants of childhood pyogenic meningitis in Ilorin, Nigeria. Afr J Med Med Sci. 2001;30:295-303.
  • 19. Lagunju IA, Falade AG, Akinbami FO, Adegbola R, Bakare RA.Childhood bacterial meningitis in Ibadan, Nigeria--antibiotic sensitivity pattern of pathogens, prognostic indices and outcome. Afr J Med Med Sci. 2008;37:185-91.
  • 20. World Health Organization. Epidemic and pandemic alert and response. Standardized treatment of bacterial meningitis in Africa in epidemic and non epidemic situations. 2007. www.who.int/csr/resources/publications. Last access date: 4 April 2019
  • 21. Sanya E, Taiwo S, Azeez O, Oluyombo R. Bacteria Meningitis: Problems Of Empirical Treatment In A Teaching Hospital In The Tropics. J Infect Dis. 2006;6:1.
  • 22. Ozumba UC. Acute bacterial meningitis in Enugu, Nigeria. 1 April 1989 to 31 March 1993. Cent Afr J Med. 1995;41:54-9.
  • 23. Ogunlesi TA, Okeniyi JA, Oyelami OA. Pyogenic meningitis in Ilesa, Nigeria. Indian Pediatr. 2005;42:1019-23.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research article
Authors

Adejoke Adijat Joseph 0000-0002-8316-4363

Michael Abel Alao This is me 0000-0003-0109-4435

Tunde Oladipo This is me 0000-0003-0109-4435

Samuel Sunday Taiwo This is me 0000-0002-8316-4363

Gbenga Olutade Popoola This is me 0000-0003-2828-9558

Oluyemi Adesoji Joseph This is me 0000-0001-5677-5380

Publication Date July 29, 2019
Published in Issue Year 2019 Volume: 3 Issue: 7

Cite

APA Joseph, A. A., Alao, M. A., Oladipo, T., Taiwo, S. S., et al. (2019). A review of bacteriological profile of acute pyogenic meningitis in a tertiary care center in Southwest Nigeria. Journal of Surgery and Medicine, 3(7), 464-468. https://doi.org/10.28982/josam.524140
AMA Joseph AA, Alao MA, Oladipo T, Taiwo SS, Popoola GO, Joseph OA. A review of bacteriological profile of acute pyogenic meningitis in a tertiary care center in Southwest Nigeria. J Surg Med. July 2019;3(7):464-468. doi:10.28982/josam.524140
Chicago Joseph, Adejoke Adijat, Michael Abel Alao, Tunde Oladipo, Samuel Sunday Taiwo, Gbenga Olutade Popoola, and Oluyemi Adesoji Joseph. “A Review of Bacteriological Profile of Acute Pyogenic Meningitis in a Tertiary Care Center in Southwest Nigeria”. Journal of Surgery and Medicine 3, no. 7 (July 2019): 464-68. https://doi.org/10.28982/josam.524140.
EndNote Joseph AA, Alao MA, Oladipo T, Taiwo SS, Popoola GO, Joseph OA (July 1, 2019) A review of bacteriological profile of acute pyogenic meningitis in a tertiary care center in Southwest Nigeria. Journal of Surgery and Medicine 3 7 464–468.
IEEE A. A. Joseph, M. A. Alao, T. Oladipo, S. S. Taiwo, G. O. Popoola, and O. A. Joseph, “A review of bacteriological profile of acute pyogenic meningitis in a tertiary care center in Southwest Nigeria”, J Surg Med, vol. 3, no. 7, pp. 464–468, 2019, doi: 10.28982/josam.524140.
ISNAD Joseph, Adejoke Adijat et al. “A Review of Bacteriological Profile of Acute Pyogenic Meningitis in a Tertiary Care Center in Southwest Nigeria”. Journal of Surgery and Medicine 3/7 (July 2019), 464-468. https://doi.org/10.28982/josam.524140.
JAMA Joseph AA, Alao MA, Oladipo T, Taiwo SS, Popoola GO, Joseph OA. A review of bacteriological profile of acute pyogenic meningitis in a tertiary care center in Southwest Nigeria. J Surg Med. 2019;3:464–468.
MLA Joseph, Adejoke Adijat et al. “A Review of Bacteriological Profile of Acute Pyogenic Meningitis in a Tertiary Care Center in Southwest Nigeria”. Journal of Surgery and Medicine, vol. 3, no. 7, 2019, pp. 464-8, doi:10.28982/josam.524140.
Vancouver Joseph AA, Alao MA, Oladipo T, Taiwo SS, Popoola GO, Joseph OA. A review of bacteriological profile of acute pyogenic meningitis in a tertiary care center in Southwest Nigeria. J Surg Med. 2019;3(7):464-8.