Bacterial meningitis in Saudi Arabia: The Impact of Haemophilus influenzae Type b Vaccination

Abstract

SummaryBacterial meningitis is one of the major causes of morbidity and mortality in children. A retrospective chart review of all cases of culture-proven bacterial meningitis in children was conducted in a tertiary care facility in the King Fahad National Guard Hospital (KFNGH), Riyadh. Sixty-seven patients with culture- proven meningitis were reviewed. Bacterial meningitis is more common in children under 2 years of age (85%). Haemophilus influenzae type b (Hib) was the most common organism causing meningitis in children (57%). Streptococcus pneumoniae was the second most common organism (31%) followed by group B streptococcus in (7.5%). Fever, lethargy and vomiting were the most common presenting symptoms, occurring in 95%, 72%, and 66% respectively. The calculated incidence of Hib in KFNGH is 40/100,000. This incidence decreased dramatically after the initiation of routine infant vaccination in KFNGH with the conjugate Hib vaccine in April 1998. Outcome of Hib meningitis was good in 85% while outcome of Streptococcus pneumoniae was good in (53%). 43% of S. pneumoniae were resistant to penicillin. There was no cephalosporin-resistant isolate identified during the study period. Mortality due to meningitis was 4 (6%), 3 patients died due to S. pneumoniae and one due to Hib. Since Hib is the most common organism causing meningitis in Saudi Arabian children, mass vaccination of all Saudi children should be mandatory.