Epidemiological Study of Bacterial Meningitis in Tunisian Children Using Molecular Method, 2014-2017

Background: Since the 1990s, a change in the bacterial meningitis epidemiology has been achieved through vaccination. In Tunisia, the main causative pathogens are Streptococcus pneumoniae, Neisseria  meningitidis and Haemophilus influenzae serotype b (Hib). Only vaccination against Hib was introduced since 2011. We proposed to study the epidemiology of bacterial meningitis in the period 2014-2017 in Tunisia. Study-design: A prospective cohort study. Methods: Overall, 111 samples of cerebrospinal fluid from children were tested by 2 real-time PCRs (rt-PCR): a multiplex detecting pneumococcal and meningococcal DNA and a singleplex detecting Hib. All samples were tested using conventional methods and culture positive samples were typed. Results: Using rt-PCR, 62 bacterial meningitis cases have been detected: 10 more than conventional methods. This result showed a general decrease in bacterial meningitis cases. S. pneumoniae was predominant (70.97%) followed by N. meningitidis (27.42%) and Hib (1.61%). The main serotypes were 14, 19F, 6A/B and 23F for S. pneumoniae and serogroup B for N. meningitidis . Most cases occurred during cold period and children under one year were more affected. Conclusion: Our study showed an absence of Hib meningitis cases and the predominance of pneumococcal cases. Such epidemiological study might contribute to change the general view of national vaccination strategy.