Pattern of cerebrospinal fluid analysis in children above the neonatal age as seen at the University of Port Harcourt Teaching Hospital

Oluwajenyo, Awopeju Abimbola Temitayo; Eberechukwu, Yaguo-Ide Lucy

doi:10.4103/0795-3038.197755

Cited by 3 publications

(4 citation statements)

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“…9 Pyogenic Meningitis is an alarming condition related to increase in mortality and morbidity. 10 Bacterial meningitis was considered as an epidemic and causes death of 70% of population effected by it before invention of antibiotic as a cure in 1940. Antibiotics have reduced the mortality rate up to 25% but this rate has been static since last 25 years and no further reduction DOI: 10.29309/TPMJ/2020.27.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of pyogenic meningitis in a Tertiary Care Hospital of Sindh.

Siyal

Jamali

Qambrani

2020

TPMJ

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Objectives: The current study aimed to find out the prevalence of pyogenic meningitis in the local population of Peoples University of Medical and Health Sciences Hospital Nawabshah. Study Design: Descriptive Cross Sectional study. Setting: Pediatric Ward of People University of Medical and Health Sciences Hospital, Nawabshah. Period: 1 year from November 2018 to October 2019. Material & Methods: Using self-designed questionnaire. Patient’s samples were send for relevant investigations i.e. Blood culture and CSF examination and their results were recorded in proforma. Statistical Package for Social Science (SPSS) version 21 was used for data analysis. Results: Mean age of the children was 7 Years with a standard deviation of 2.4 years. 57% of the sample consist of boys while 43% were girls. Diagnosis of pyogenic meningitis was confirmed in 52.08% of the cases and fever was present in 100% cases and was the most common clinical presentation followed by headache (67%), Vomiting (44%) and fits (28%). Mean protein level was 235 mg/dl in the diagnosed cases. Mean sugar level in CSF of diseased children was 35 mg/dl with significant p-value of 0.0005. Conclusion: Pyogenic meningitis is highly prevalent that is 52.08% in current study. Its morbidity and mortality can be reduced by early recognition and prompt treatment.

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Section: Introductionmentioning

confidence: 99%

Prevalence of pyogenic meningitis in a Tertiary Care Hospital of Sindh.

Siyal

Jamali

Qambrani

2020

TPMJ

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“…Our CSF culture results as confirmed by mRT-PCR showed 6.7% recovery rate. Previous reports from Nigeria using culture of CSF samples had shown bacterial isolation rates ranging from 1.7% to 16.7% (15)(16)(17)(18)(19)(20). Results from culture with latex agglutination had rate of 2.9-15.3% (21,22) while results from latex agglutination only was between 9.1-20.4% (23).…”

Section: Discussionmentioning

confidence: 92%

Molecular detection and characterization of bacteria from CSF samples of patients with suspected cerebrospinal meningitis in parts of northern Nigeria using metagenomic DNA extracts

Peletiri¹,

Ikeh²,

Ayanbimpe³

et al. 2021

Af J Clin Exp Micro

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Background: The most commonly used approaches for detection and characterization of bacterial pathogens of meningitis in developing countries include culture, Gram stain, and latex agglutination. The positivity rate of culture is relatively low due to suboptimal storage and transportation conditions, culture practice, and/or antibiotic treatment administered before specimens are collected. Specimens that yield no growth in culture can still be analyzed using molecular methods, and metagenomic DNA (mDNA) extracted directly from clinical samples (CSF) can be used. We aimed to detect and characterize three major bacterial causes of cerebrospinal meningitis (CSM); Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae using mDNA extracted directly from CSF samples. Methodology: Metagenomic DNA templates were prepared directly from CSF specimens collected from 210 patients with suspected CSM. A multiplex Real Time PCR (mRT-PCR) using the ABI StepOne Plus Machine and Taqman Probe chemistry was used in the molecular detection, while serogroup/serotype-specific singleplex RT-PCR was used to characterize all positives samples. Results: Eighty-eight (41.9%) of the 210 samples were positive with the mRT-PCR assay for one or a combination of two of the three bacteria. Of these, 59 (67.1%) were N. meningitidis, 2 (2.3%) were H. influenzae, 3 (3.4%) were S. pneumoniae, 15 (17 %) had co-infections of N. meningitidis with H. influenzae, and 9 (10.2%) had co-infections of H. influenzae and S. pneumoniae. The serogroups of N. meningitidis encountered were A (13.5%), B (23%), C (8.1%), W135 (8.1%), X (5.4%), Y (32.4%), and non-groupable (9.5%). The serotypes of H. influenzae were Hia (3.8%), Hib (57.7%), Hic (3.85%), Hie (11.5%) and Hif (23.1%). The serotypes of S. pneumoniae were Wxy1 (8.3%), Wxy4 (33.3%), Wxy5 (50.0%), and Wxy9 (8.3%). Conclusion: Multiplex RT-PCR is a fast and accurate method for detecting and characterizing serogroups/serotypes of major bacteria implicated in CSM. Isolating DNA directly from CSF improves turnaround time, which will speed up patient care and management. Keywords: Cerebrospinal meningitis, metagenomic DNA, multiplex Real Time PCR, Northern Nigeria French title: Détection moléculaire et caractérisation de bactéries à partir d'échantillons de LCR de patients suspectés de méningite cérébrospinale dans certaines parties du nord du Nigéria à l'aide d'extraits d'ADN métagénomique Contexte: Les approches les plus couramment utilisées pour la détection et la caractérisation des agents pathogènes bactériens de la méningite dans les pays en développement comprennent la culture, la coloration de Gram et l'agglutination au latex. Le taux de positivité de la culture est relativement faible en raison des conditions de stockage et de transport sous-optimales, des pratiques de culture et/ou du traitement antibiotique administré avant le prélèvement des échantillons. Les échantillons qui ne donnent pas de croissance en culture peuvent toujours être analysés à l'aide de méthodes moléculaires, et l'ADN métagénomique (ADNm) extrait directement d'échantillons cliniques (LCR) peut être utilisé. Nous visions à détecter et à caractériser trois causes bactériennes majeures de la méningite cérébrospinale (CSM); Neisseria meningitidis, Haemophilus influenzae et Streptococcus pneumoniae à l'aide d'ADNm extrait directement d'échantillons de LCR. Méthodologie: Des matrices d'ADN métagénomique ont été préparées directement à partir d'échantillons de LCR prélevés sur 210 patients suspects de CSM. Une PCR multiplex en temps réel (mRT-PCR) utilisant la chimie de la machine ABI StepOne Plus et de la sonde Taqman a été utilisée pour la détection moléculaire, tandis que la RT-PCR monoplex spécifique au sérogroupe/sérotype a été utilisée pour caractériser tous les échantillons positifs. Résultats: Quatre-vingt-huit (41,9%) des 210 échantillons étaient positifs avec le test mRT-PCR pour une ou une combinaison de deux des trois bactéries. Parmi ceux-ci, 59 (67,1%) étaient N. meningitidis, 2 (2,3%) étaient H. influenzae, 3 (3,4%) étaient S. pneumoniae, 15 (17%) avaient des co-infections de N. meningitidis avec H. influenzae et 9 (10,2%) avaient des co-infections à H. influenzae et S. pneumoniae. Les sérogroupes de N. meningitidis rencontrés étaient A (13,5%), B (23%), C (8,1%), W135 (8,1%), X (5,4%), Y (32,4%) et non groupables (9,5%). Les sérotypes de H. influenzae étaient Hia (3,8%), Hib (57,7%), Hic (3,85%), Hie (11,5%) et Hif (23,1%). Les sérotypes de S. pneumoniae étaient Wxy1 (8,3%), Wxy4 (33,3%), Wxy5 (50,0%) et Wxy9 (8,3%). Conclusion: La RT-PCR multiplex est une méthode rapide et précise de détection et de caractérisation des sérogroupes/sérotypes des principales bactéries impliquées dans le CSM. Isoler l'ADN directement du LCR améliore le temps de traitement, ce qui accélérera les soins et la gestion des patients. Mots clés: méningite cérébro-spinale, ADN métagénomique, PCR multiplex en temps réel, nord du Nigéria

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Section: Resultsmentioning

confidence: 99%

“…23 There were 10 articles that fell within this category with prevalence rates ranging from 1.7% to 20.4%. 24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44 Two studies also utilised the molecular approach in the identification of bacterial aetiologies. 25,33 The second category of studies included those that reported the varying serogroups of N. meningitidis, as well as the serotypes of H. influenzae and S. pneumoniae associated with meningitis in Nigeria.…”

Section: Resultsmentioning

confidence: 99%

Epidemic forecast and preparedness for explosive-cerebrospinal meningitis outbreak in Nigeria using the preventive vaccination strategy

Peletiri,

Nwachukwu,

Peletiri

et al. 2023

African Journal of Laboratory Medicine

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Background: Within the African meningitis belt, yearly outbreaks of cerebrospinal meningitis (CSM), with incidence rates of 10–100 cases per 100 000 population, are typically punctuated by explosive epidemics occurring every 8–12 years, with incidence rates that can exceed 1000 cases per 100 000 population. From 1928 to 2018, Nigeria recorded the highest number (21%) of cases in the region. The reactive vaccination strategy, a protocol with major drawbacks, has been the vaccination method utilised in Nigeria.Aim: This review highlights the need for governments within the African meningitis belt to start preparations against the next explosive CSM epidemic expected to occur between 2024 and 2028 using the preventive vaccination strategy.Methods: We performed a literature search on the Google Scholar search engine using relevant search strings and included studies and reports between 1905 and 2022 that met set criteria.Results: Neisseria meningitidis serogroups A, B, C, W135, X, and Y; Haemophilus influenzae serotypes a, b, c, e, and f; and Streptococcus pneumoniae serotypes 1, 4, 5, 6, 9, 19, 19F, and 20 were implicated as aetiologies. However, the reactive vaccination strategy was only used against N. meningitidis A or C, H. influenzae b, and pneumococcal conjugate vaccine. Between 2011 and 2017, a polysaccharide vaccine (ACW or ACYW) active against serogroups A, C, W and Y was used within the African meningitis belt for the first time. Varying genotypes of N. meningitidis, H. influenzae and S. pneumoniae were identified.Conclusion: Our results revealed a very high success rate for the preventive vaccination strategy.What this study adds: In order to ensure reductions in the morbidity and mortality associated with invasive CSM, the Federal Ministry of Health, Nigeria, should leverage existing knowledge of the circulating serogroups, serotypes, and genotypes of the primary bacterial aetiologies and commence the implementation of the preventive vaccination strategy.

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Pattern of cerebrospinal fluid analysis in children above the neonatal age as seen at the University of Port Harcourt Teaching Hospital

Cited by 3 publications

References 3 publications

Prevalence of pyogenic meningitis in a Tertiary Care Hospital of Sindh.

Prevalence of pyogenic meningitis in a Tertiary Care Hospital of Sindh.

Molecular detection and characterization of bacteria from CSF samples of patients with suspected cerebrospinal meningitis in parts of northern Nigeria using metagenomic DNA extracts

Epidemic forecast and preparedness for explosive-cerebrospinal meningitis outbreak in Nigeria using the preventive vaccination strategy

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