Etude épidémiologique rétrospective des méningites bactériennes au niveau de la wilaya de Ghardaïa

Abstract

Meningitis is an inflammatory process, generally of infectious origin, that affects the meninges. It is classified according to its cause into viral, bacterial, fungal, and parasitic meningitis. Although less common, bacterial meningitis remains the most severe form, with high mortality and neurological morbidity rates, despite advances in diagnosis and treatment. The aim of this study was to assess the frequency, describe the cytobacteriological and clinical characteristics, and identify the main pathogens responsible for bacterial meningitis. A retrospective study conducted over a four-year period (January 2020 to August 2025) included 42 hospitalized patients who were managed for confirmed or suspected bacterial meningitis, based on cytobacteriological and biochemical cerebrospinal fluid (CSF) analysis, at the microbiology laboratories of three hospitals in the Wilaya of Ghardaïa: the Specialized Hospital "EHS Mother and Child" Gaddi Bakir in the neonatology and pediatrics departments of Ghardaïa, the Public Hospital Establishment Tirichine Brahim (EPH of Ghardaïa), and the Public Hospital Establishment 18 February (EPH of Metlili).The results showed that the overall male-to-female ratio was 1.625 in favor of males (61.90%). Infants under 2 years of age were the most affected (47.62%); in this age group, the main clinical signs included fever (100%), bulging fontanelle (50.5%), hypotonia (50%), and vomiting (44.4%). In patients aged 2 years and older, the main clinical signs were fever (100%) and headache (84.61%), followed by meningeal irritation signs, including neck stiffness (61.54%), Kernig’s, and Brudzinski's signs (61.53%). Cerebrospinal fluid cyto-biochemical analysis revealed a predominance of turbid appearance (64.1%), hyperleukocytosis (leukocytes > 500) in 57.14% of cases, hypoglycorrhachia (71.43%), and hyperproteinorrachia (90.48%). The causative pathogen was identified in 10 patients (23.8%), with the majority of patients showing negative CSF cultures. The main isolated pathogen was Streptococcus pneumoniae (90%), while Klebsiella pneumoniae was isolated in one patient. In total, 7 patients out of 42 with bacterial meningitis died, yielding a mortality rate of 16.6%. In light of these findings, bacterial meningitis predominantly affects infants and remains a severe condition with considerable mortality. Streptococcus pneumoniae continues to be the leading pathogen in bacterial meningitis.