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867 Epidemiology of Bacterial Meningitis in Tunisian Children (2000–2011)
  1. H Smaoui,
  2. A Bouafsoun,
  3. A Kechrid
  1. Microbiology, Children’s Hospital of Tunis, Tunis, Tunisia


Bacterial meningitis is associated with high mortality and neurological squeal world wide.

We reported epidemiological characteristics of laboratory confirmed bacterial meningitis in children during 2000 to 2011 period.

We analyzed all laboratory confirmed bacterial meningitis cases. The serotypes and serogroups were determined by slide agglutination. Antibiotic susceptibility was determined by disk diffusion method according to CA-SFM guidelines. Beta-lactamase production was analyzed using cefinase test. MIC of beta-lactams was determined by E-test method (AB BIODISK).

During the study period we have collected 486 cases of bacterial meningitis: 157 cases of S. pneumoniae (32.3%), 118 of N. meningitidis (24.3%), and 99 of H. influenzae (20.4%). Most cases (66.5%) occurred in children under 3 years. The most frequent serotype among S. pneumoniae was 14 (27.2%) followed by 23F (9%). The majority of N meningitidis strains belonged to serogroup B (72.9%) and 88.8% of H. influenzae strains to serotype b.

Before Hib conjugate vaccine introduction (2000–2002), H. influenzae were the first species responsible for meningitis (40%). During vaccine generalisation (2003–2005) we noted a decrease in Hib meningitis. At the beginning of 2006, Hib vaccination was stopped and we observed an increase of Hib meningitis cases. Antimicrobial susceptibility studies show that 43.6% and 60% respectively of S. pneumoniae and N. meningitidis strains had reduced susceptibility to penicillin. Among H. influenzae 47.3% was beta-lactamase producing.

The data presented in this study demonstrate that S. pneumoniae is the most frequent in bacterial meningitis in children and that beta-lactams resistance is frequent in our hospital.

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