Pneumococcal and Haemophilus influenzae meningitis in a children's hospital in Ethiopia: serotypes and susceptibility patterns

Streptococcus pneumoniae and Haemophilus influenzae are responsible for mos t pyogenic meningitis cases in children in Ethiopia. Resistance of S. pneum oniae and H. influenzae to penicillin and chloramphenicol respectively has been reported globally. Resistance has been related to specific serotypes o f S. pneumoniae or to beta-lactamase-producing H. influenzae strains. This study describes the serotypes/serogroups and susceptibility pattern of the: two organisms causing meningitis in Ethiopian children. There were 120 cas es of meningitis caused by S. pneumoniae (46) and H. influenzae (74) over a period of 3 years (1993-95). Nineteen children died from pneumococcal and 28 from haemophilus meningitis. Penicillin-resistant pneumococcal meningiti s (4/8 = 50%) caused a greater mortality rare than penicillin-suscepcible p neumococcal meningitis (15/38 = 39%). Common serotypes accounting for 76% o f S. pneumoniae were type 14, 19F, 20, 1, 18 and 5; and serotypes 14, 19F a nd 7 (accounting for 17% of strains) showed intermediate resistance to peni cillin G. 97% of the H. influenzae isolates were type b, and in only two ca ses beta-lactamase-producing. 72% of isolates of the S. pneumoniae we ident ified belong to serotypes preventable by a 9-valent vaccine. Our study high lighs the possibility of resistant pyogenic meningitis in children in Ethio pia due to emerging resistant strains of S. pneumoniae and H. influenzae is olates.