465 SIGNIFICANT SHIFT IN THE BACTERIOLOGY OF MENINGITIS IN EARLY LIFE

Abstract

Changes in bacterial causes of meningitis over the past years has led to the use of various empiric antibiotic regimens. A review of 248 cases of meningitis among children less than 17 years of age during the period 1973 to 1978 documented a significant shift in bacteriologic agents of meningitis in early life. Group B streptococcus (GBS)(59%), gram-negative bacilli (GNB) (26%), Haemophilus influenza type B (HIB)(9%), Neisseria meningitidis (NM)(3%), and Streptococcus pneumoniae (SP)(3%) caused meningitis in the first month of life. In the second month, HIB (33%), SP(25%), NM(25%), and GBS(17%) were the etiologic agents; GNB were no longer isolated. GBS (33.3%) continued to be a major cause of meningitis in the third month along with HIB (33.3%), and SP (33.3%). HIB (73%), SP (14%), and NM (13%) were the only bacterial isolates beyond three months. These data document two important shifts early in life: 1. HIB is becoming more common in the first month. 2. GNB are no longer a significant cause of meningitis in the second month. Based on the latter observation, ampicillin and chloramphenicol would be the most appropriate antibiotic regimen for the initial management of meningitis in children beyond the first month. Further studies, however, will be needed to determine the efficacy of this antibiotic combination against GBS which remains a major problem through the third month.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD