Childhood meningitis in Kuwait: epidemiology of etiologic agents and the need for pneumococcal disease prevention.

OBJECTIVE To investigate the epidemiology of the etiologic agents causing bacterial meningitis in Kuwait. SUBJECTS AND METHODS This is a retrospective analysis of the medical records of children 1 month to 12 years old who had cerebrospinal fluid (CSF) findings consistent with meningitis. Patients were identified from the records of the Departments of Microbiology and Communicable Diseases in six regional hospitals during 2001. They were divided into bacterial and viral infective groups. RESULTS Ninety children had CSF findings consistent with meningitis, 44 bacterial (23 culture proven, 21 probable) and 46 viral. Streptococcus pneumoniae and Neisseria meningitidis were the most frequently isolated organisms (44 and 30%, respectively). A 2-month-old child had Haemophilus influenzae and was the only mortality of this series. S. pneumoniae is the leading bacterial agent causing meningitis in children under the age of 1 year; 61% had bacterial meningitis compared to 37% with viral meningitis. Sequelae were encountered in 23% of bacterial cases. CONCLUSION The results indicate that S. pneumoniae is the leading bacterial agent causing meningitis, indicating a need for the introduction of polyvalent pneumococcal vaccine.