Nagaraj Geetha, Govindan Vandana, Kumar C P Girish, Awasthi Shally, Das Bimal Kumar, Gautam Hitender, Biswas Debasis, Ezhilarasi S, Nivedhana S, Bavdekar Ashish, Lingegowda Ravikumar Kadahalli
Central Research Laboratory, Kempegowda Institute of Medical Sciences, Banashankari 2nd Stage, Bengaluru, 560070, India.
ICMR-National Institute of Epidemiology, Chennai, 600077, India.
Eur J Clin Microbiol Infect Dis. 2025 Jun 28. doi: 10.1007/s10096-025-05198-2.
Acute bacterial meningitis (ABM) is a medical emergency that requires early diagnosis and prompt treatment. Understanding bacterial etiology and resistance patterns is critical for optimal management and reduction of mortality. Nucleic acid amplification tests, with high sensitivity and rapid results, are valuable for diagnosing ABM. This study aimed to identify the etiological agents of acute bacterial meningitis in children aged 1-59 months in India.
2004 CSF were collected from Children aged 1-59 months admitted to the ward/ ICU of seven study sites with probable meningitis between 2019 and 2023. The samples were subjected to conventional culture, 16s rRNA PCR, real-time Multiplex PCR for detecting S.pneumoniae, H.influenzae type b, N.meningitidis, and Quadraplex real-time Multiplex PCR to determine S.pneumoniae serotypes.
A total of 2,004 cerebrospinal fluid (CSF) samples were analysed for ABM in children over a 51-month period. The majority of cases (61%) involved children aged 0-12 months, with males comprising 63% of the study population. Laboratory confirmation identified ABM pathogens in 13.6% of cases, predominantly S.pneumoniae (10.2%), followed by H.influenzae (2.3%) and N.meningitidis (1%). Serotyping revealed 20 pneumococcal serotypes, with 19 F, 6 A, and 6B being the most prevalent, and 32.5% resistance to ceftriaxone was observed among pneumococcal isolates.
This study underscores the diagnostic value of molecular techniques in accurately determining the burden of ABM in young children, with Streptococcus pneumoniae identified as the predominant pathogen. These findings underscore the need for molecular methods, enhanced vaccination coverage, and continued surveillance to monitor pathogen prevalence, serotype distribution, and antimicrobial resistance patterns.
急性细菌性脑膜炎（ABM）是一种医疗急症，需要早期诊断和及时治疗。了解细菌病因和耐药模式对于优化治疗和降低死亡率至关重要。核酸扩增检测具有高灵敏度和快速出结果的特点，对诊断ABM很有价值。本研究旨在确定印度1至59个月大儿童急性细菌性脑膜炎的病原体。
2019年至2023年期间，从七个研究地点的病房/重症监护室收治的疑似脑膜炎的1至59个月大儿童中收集了2004份脑脊液样本。对样本进行常规培养、16s rRNA PCR、用于检测肺炎链球菌、b型流感嗜血杆菌、脑膜炎奈瑟菌的实时多重PCR，以及用于确定肺炎链球菌血清型的四重实时多重PCR。
在51个月的时间里，共对2004份儿童脑脊液样本进行了ABM分析。大多数病例（61%）为0至12个月大的儿童，男性占研究人群的63%。实验室确诊在13.6%的病例中发现了ABM病原体，主要是肺炎链球菌（10.2%），其次是流感嗜血杆菌（2.3%）和脑膜炎奈瑟菌（1%）。血清分型显示有20种肺炎球菌血清型，其中19F、6A和6B最为常见，在肺炎球菌分离株中观察到32.5%对头孢曲松耐药。
本研究强调了分子技术在准确确定幼儿ABM负担方面的诊断价值，肺炎链球菌被确定为主要病原体。这些发现强调了需要采用分子方法、提高疫苗接种覆盖率，并持续监测以监测病原体流行情况、血清型分布和抗菌药物耐药模式。
