Study of bacterial agents of meningitis in children and detection of antibiogram patterns in Hamadan

Introduction: Bacterial meningitis is still one of the most dangerous infectious diseases and causes serious complications and mortalities in children. The aim of this study was to identify the most common of bacterial agents causing meningitis in children under 10 years old and to detect their resistance to antibiotics in patients who referred to the educational hospital of Hamadan. Materials and Methods: Overall 582 children suspected to meningitis were investigated for CSF cultures, frequency of age groups, sex and seasons and antibiogram patterns from 1998 to 2000. Data were gathered through a questionnaire and analyzed using Epi6 software. The species were identified by biochemical and serological methods. Antibiogram tests were also performed by Gel- diffusion method of Kirby- Bauer. Findings: Out of 582 children suspected to meningitis, 46 cases (7.9%) had positive bacterial culture that 58.9% were gram positive and 41.1% were also gram negative bacteria. The most common species were S. pneumonia 23.9%, S. aureus 13.1%, E. coli 10.9%, N. meningitis and P. aeroginosa each 6.5% respectively. The most positive cases were observed in children 0-2 age group (28.3%), male (54.4%) and during Autumn (43.7%). The results of antibiogram showed that the most effective antibiotics were ceftizoxime, kanamycin and gentamycin for both gram positive and gram negative bacteria, but they showed high resistance to amoxicilin, ampicillin and chloramphenicol. Conclusion: The present study showed that gram positive bacteria in particular, Streptococcus pneumonia and Staphilococcus aureus are predominant causes of bacterial meningitis in children under 10 years old in these regions. Most species showed high resistance to routine antibiotics such as amoxicillin, ampicillin and choramphenicol.