Epidemiologic study of bacterial meningitis in Jakarta and Tangerang: preliminary report

OBJECTIVE: To identify the cause of bacterial meningitis in children >1 month of age and <5 years of age in several hospitals in Jakarta and Tangerang, Indonesia. METHODS: Hospital-based, prospective surveillance study of 100 subjects between 1 month and 5 years of age. Subjects meeting inclusion criteria were evaluated for clinical and laboratory findings of bacterial meningitis. RESULTS: Of 16 subjects enrolled thus far, 11 have been diagnosed as bacterial meningitis. Of these 11, 6 had positive cerebrospinal fluid (CSF) cultures (2 with Haemophilus influenzae and one each with Neisseria meningitidis, Staphylococcus aureus, Klebsiella ozaenae and Escherichia coli). Three of the 6 had positive latex agglutination tests (LAT; 2 H. influenzae and 1 N. meningitidis); LAT was negative for all 10 with negative CSF culture. CSF Gram-stained smear was positive only for the subject with E. coli. CONCLUSIONS: The number of children admitted with bacterial meningitis has been declining, perhaps because of early treatment with antibiotics in the community. Of culture-positive cases 33% have been caused by H. influenzae, but this result is based on few patients thus far. LAT has correlated well with culture, whereas Gram stain has had low sensitivity, perhaps reflecting deficiencies in technique.