Bacterial pathogens and outcome determinants of childhood pyogenic meningitis in llorin, Nigeria

Abstract

Empirical antimicrobial therapy remains justifiable in childhood pyogenic meningitis (CPM), but the continuing efficacy in a particular setting requires periodic microbiological surveillance. It was this need that informed the present five-year retrospective study of consecutive admissions for CPM at the Emergency Paediatric Unit (EPU) of the University of llorin Teaching Hospital, llorin, Nigeria. Of the 71 cerebro-spinal fluid [CSF] analyses, 41(57.6%) were Gram-smear positive (GSP). Grampositive cocci (GPC) were identified in 23 (56.1%) smears, while 14 (34.2.%) had Gram-negative bacilli (GNB). Only three (7.3%) had Gram-negative diplococci (GND). Despite corroborative biochemical findings, the remaining 30 (42.3%), including two with tuberculous meningitis proved smear-negative. GPC cases had a mean age of 4.49 ± 5.3yrs, GNB, 3.06 ± 4.8yrs and GND, 4.47 ± 4.9yrs. CSF isolates were made in 28(39.4%) cases. Streptococcus pneumoniae accounted for a predominant 22 (78.6%) (P = 0.00), Haemophilus influenzae for 2 (7.1 %), and Neisseria meningitidis for only 1(3.5%) case.