Etiology of community-acquired bacterial meningitis in children at a tertiary-care centre in Montreal, Canada.

OBJECTIVES

This study aimed to identify the bacteria responsible for community-acquired bacterial meningitis in infants and children.

METHODS

This was a retrospective cohort study including children aged 1 day to 18 years with confirmed bacterial meningitis, evaluated at a tertiary-care, Canadian emergency department between 2014 and 2022. The primary outcome was the pathogen identified. Other variables of interest were complications, age, and diagnostic method. Medical charts were reviewed by a co-investigator and 25% were assessed in duplicate.

RESULTS

All 79 eligible cases were included. The main causal agents were Group B (GBS) (n = 20; 25%), (n = 16; 20%), (n = 16; 20%), and (n = 9; 11%). Etiology exhibited age-dependent variations, with 85% of GBS and 100% of infections in children under 2 months. All pneumococcal and Group A cases were in children older than 6 months. All children infected by were vaccinated but the serotype was not covered by vaccination in 7/8 infections. All children with were either too young to be vaccinated (n = 10) or infected by a serotype not covered by the given vaccine. Fifty-five bacteria were identified by cerebrospinal fluid culture, 17 by Polymerase Chain Reaction (PCR), and 7 by both methods.

CONCLUSION

GBS is now the leading etiology of paediatric community-acquired bacterial meningitis at our centre. The etiology of bacterial meningitis varies greatly by age. Future studies should focus on improving the serotype spectrum of vaccines, identifying strategies to lower GBS infection, and improving the use of PCR as a diagnostic tool.