CHILDHOOD BACTERIAL-MENINGITIS BEYOND THE NEONATAL-PERIOD IN SOUTHERNNIGERIA - CHANGES IN ORGANISMS ANTIBIOTIC SUSCEPTIBILITY

Of 253 culture proven cases of bacterial meningitis in infants aged ov er a month and children up to one year old in Benin City, Nigeria, fro m 1985-1990, 49.8% were due to N. meningitidis, 21.4% S. pneumoniae, 1 5.4% H. influenzae and 13.4% other organisms, including S. aureus and enterobacteriaceae. Compared to the period 1974-1984 in Southern Niger ia, N. meningitidis has replaced S. pneumoniae as the commonest organi sm. N. meningitidis was relatively infrequent below two years of age w hile H. influenzae was rare after five years. Approximately half of is olates of S. aureus and enterobacteriaciae were in infants aged six mo nths or less. The proportions of sensitive strains of three common org anisms to three commonly used drugs were chloramphenicol (95.3%) > amp icillin (83.9%) > penicillin (67.6%). Resistance to penicillin has inc reased while simultaneous resistance to ampicillin and chloramphenicol has emerged as a new problem among the three common bacteria. It is c oncluded that although the combination of ampicillin and chloramphenic ol is still reasonable for initial ''blind'' therapy of meningitis, th e emergence of multiple drug resistance suggests the need for consider ation of a revision of current practice. The third generation cephalos porins are suggested as a suitable alternative.