Background: Since the 1990s, the epidemiology of bacterial meningitis worldwide has changed thanks to vaccination. In
Tunisia, the main causative pathogens were
Streptococcus pneumoniae
,
Neisseria meningitidis
and
Haemophilus influenzae
serotype b
(Hib). Only Hib vaccination was available during our study period.
Objectives: We performed a laboratory case report based-study of suspected bacterial meningitis in Northern Tunisia from
January 2014 to June 2017.
Methods: CSF samples obtained from children beyond neonatal age with suspicion of meningitis were tested by two real
time PCRs, targeting pneumococcus, meningococcus and Hib, and conventional methods.
Results: Using real-time PCR, 63 were positive including ten supplementary cases compared to conventional methods. A
general decrease of bacterial meningitis cases was demonstrated comparing to previous data.
Pneumococcus was predominant
(69.84%) followed by
meningococcus (28.57%) and Hib (1.59%). The main serotypes were 14, 19F, 6B and 23F for
pneumococcus
and serogroup B for
meningococcus. Most cases occurred during cold season and children under one year were the most affected
by bacterial meningitis.
Conclusion: Our study suggests the predominance of pneumococcal cases. It may provide valuable data on meningitis
epidemiology before the introduction of pneumococcal vaccine, which may be useful for future evaluation.
