Typhoid fever in children: clinical presentation and risk factors

Abstract

Abstract The causative agents of
acute bacterial meningitis vary from
time to time and from place to place.
In addition, changes in pathogen’s
sensitivity to antibiotics in use occur.
The study was undertaken to identify
the pattern and susceptibility of
pathogens to antibiotics among children beyond neonatal period for
prompt empirical treatment of this
important cause of morbidity and
mortality especially in developing
countries.
Objective. To identify the pattern and
susceptibility of pathogens in acute
bacterial meningitis among children
aged one month to 12 years at
ABUTH Shika, Zaria.
Method: This was a prospective
study carried out in children presenting to Emergency Pediatric Unit of
ABUTH Shika, Zaria, from October
1
st 2005 to September 30th, 2006.
Children who met the inclusion criteria for lumbar puncture were consecutively recruited. Cerebrospinal
fluid (CSF) samples were collected
for microscopy, culture, sensitivity,
and Latex Particle Agglutination
(LPA) test. Sixty-six (66) patients
satisfied the criteria for acute bacterial meningitis and were studied.
Results: The prevalence of acute bacterial meningitis in this study was
6.9%. Sixty-six patients with acute
bacterial meningitis were identified
using 3 diagnostic methods (Gram
stain, culture and LPA). The 3 commonest organisms were Streptococcus pneumoniae 34 (51.5%), Haemophilus influenzae 18 (27.3%),
and Neisseria meningitidis 12
(11.2%). The sensitivity of the isolates to three commonly used noncephalosporin antibiotics was
chloramphenicol 74.4%, penicillin
38.5%, and ampicillin 2.6%. The
sensitivity to the cephalosporin was
cefotaxime 97.4%, and ceftriaxone
89.7% while that to Ofloxacin, a
quinolone, was 100%.
Conclusion: The three commonest
bacterial agents causing post neonatal meningitis were Streptococcus
pneumoniae, Haemophilus influenzae, and Neisseria meningitidis.
There is an increasing resistance to
the three commonly used nonc e p h a l o s p o r i n a n t i b i o t i c s
(chloramphenicol, ampicillin and
penicillin) and hence, cefotaxime or
ceftriaxone should be used in the
empirical treatment of children with
suspected acute bacterial meningitis
beyond neonatal period