Bacterial Meningitis: a five-year retrospective study among patients who had attended at University of Gondar Teaching Hospital, Northwest Ethiopia

Abstract

Acute Bacterial Meningitis (ABM) is an important cause of death and long-term neurological disability. Recent Information on the relative frequency of the isolation and antibiotic susceptibility patterns of these pathogens is scarce in Ethiopia. This study was to document the microbial characteristics, the antibacterial sensitivity pattern, and seasonal variation of community acquired acute bacterial meningitis. The study was retrospective, conducted at university of Gondar referral hospital, serving the rural population of the northwest parts of Ethiopia. A total of three thousand and eighty five cerebrospinal fluid specimens submitted to the bacteriology laboratory for culture and antibiotic susceptibility patterns in a period between January 2006 and December 2010. Analysis of extracted data was performed using SPSS statistical software (Version 17).  The etiological agent had been identified in 120 (3.8%) of  the  total  3,085 CSF samples by culture. Thirty-nine (32.5%) of them were infants below the age of 12 months. S. pneumoniae was the predominant pathogen accounting for 52 (43.3%) of the  cases. Whereas N. meningitidis and H. influenzae accounted for 27(22.5%), and 12(10%), respectively. Other gram negative bacilli and S. aureus were isolated from 21(17.2%), and 11(9.2%) cases, respectively. Among gram positive organismsS.pneumoniae showed a high level of drug resistance against co-trimoxazole 44(84.3%).  Among gram negative bacteria, N.meningitidis was found to be resistant to co-trimoxazole in 25(92.5%).  E. coli and salmonella spp. were found to be resistant to most antibiotics except ciprofloxacin. Multiple drug resistance was observed in 58.3% of the isolates. S. pneumoniae remains the major etiological agent of Community Acquired Acute Bacterial Meningitis (CAABM) both in adults and children in the study area. 5.7% of S. pneumoniaewere resistances to penicillin. Further research should focus on preventable aspects CAABM of, especially pneumococcal vaccines, to reduce the disease burden.