Culture Sensitivity Pattern of Infectious Meningitis in Pediatric Population at a Tertiary Care Hospital

Abstract

Objective:

This study aims to determine the culture sensitivity pattern and clinical features of patients suffering from infectious meningitis presenting at Nishtar medical university hospital Multan, Pakistan.

Study design:

Descriptive cross-sectional study

Place and duration of study:

Pediatric department, Nishtar Hospital Multan the duration of the study was January 01, 2017 to December 31, 2017.

Method

All the children of age 1 month to 12 years with suspected meningitis were included in our study. The patients who were critically ill or immune compromised were not included in the study. All these cases were evaluated by detailed history, thorough physical examination and the necessary investigations. All the demographic data and other variables related to clinico-epidemiological features were measured and recorded using a specifically designed Proforma. The data were analyzed by using computer program SPSS 21 version.

Result

Of the 178 patients included in the final analysis, 113 (63.6%) were females and 65 (36.4%) males. The age ranged from 1 month to 12 years with a median of 31 months (6.00 - 72.50). Seventy-five percent of them were below 5 years. On the basis of investigations, bacterial meningitis was diagnosed in 91, viral meningitis in 27, tuberculous meningitis in 21 and cryptococcal meningitis in 15 patients. The most common clinical presentations of meningitis were fever, vomiting, headache, irritability, neck stiffness and altered level of consciousness. While the photophobia and fits were less common. The GCS score was more than 13 in 33 patients (18.8%) and 8-13 in 93 patients (52%). Whereas, less than eight GCS score was observed in 52 children (29.2%). Most of the complications were observed in the initial 48 hours of admission. The commonly observed complications were an altered level of sensorium, seizure, and shock. The minimum length of hospitalization was three days and the maximum was 36 days with median (IQR) of 12 days (4-15). The mortality was observed in 29 patients (16.2%) of Pediatric Department.

Conclusion Infectious meningitis is a common disease of Pakistani pediatric population. The female children of rural areas, having age less than 5 years are more prone to suffer from this disease. For effective management of infectious meningitis, the antimicrobial sensitivity data should be continuously monitored. Keywords: Meningitis, children, culture sensitivity patterns, clinical features