Table 3.
Major bacteria responsible for causing meningitis in the included studies.
| S. pneumoniae | |||||
|---|---|---|---|---|---|
| Author | Study period/duration | Region | Study details | Age group | Frequency |
| Chinchankar et al.55 | NS/2 years | West | 54 patients with ABM. Chief presentation was high fever,
refusal of feeds, altered sensorium and
seizures. • 26% of patients had meningeal signs. • 39% patients developed acute neurological complications during the hospital course. |
1 month–5 years | 39% |
| Vashishtha et al.56 | 2009–2010 | North | 67 patients with ABM Fever (91%), altered sensorium (62.7%), vomiting (50.8%), seizures (47.8%) and refusal of feeds (23.9%) were the most presenting features. |
41.5 (±26.9) months | 25.37% |
| Chauhan et al.32 | NS/1 year | North | 81 ABM cases. Observed complications included seizures (23.4%), increased intracranial pressure (20.9%), infarct on imaging (4.9%), coma (4.9%), and respiratory compromise leading to ventilator support (3.7%) | 1–59 months | 23.40% |
| Sankar et al.57 | 2002–2003 | North | 24 children with ABM | 2 months–12 years | 41.67% |
| Sahai et al.59 | 1994–1996 | South | 100 children with ABM | 1 month–12 years | 12% |
| Shameem et al.61 | NS/48 months | South | 199 cases of meningitis | 1 month–3 years | 44.70% |
| Jayaraman et al.13 | 2012–2013 | South | 257 cases of meningitis Male: female ratio in confirmed meningitis patients was 1.3:1 |
1–59 months | 82.90% |
| Ramchandran et al.33 | 2008–2010 | Multiple states | 89 cases of bacterial meningitis | 1–23 months | 13% |
| Mirdha et al.63 | 1988–1989 | North | 18 cases of bacterial meningitis | 1 month–60 years | 16.67% |
| Raza et al.64 | 2015–2017 | North | 400 CSF samples of suspected HAM | NR | 6.25%^ |
| Mital et al.65 | NS | North | 50 cases of pyogenic meningitis, 29 culture positive cases
of bacterial meningitis Male: female ratio of 5:1 |
15–70 years | 31.03% |
| Pandit et al.66 | 2002/10 months | South | 21 positive CSF samples for bacterial meningitis | 2–65 years | 9.52% |
| Mani et al.67 | 1996–2005 | South | CSF samples from 385 clinically suspected cases of pyogenic meningitis were analysed. Proof of infective agent was studied in 284 cases of meningitis | NR | 61.80% |
| Gangane and Doddamani41 | 2010–2012 | South | 308 CSF samples were collected from clinically diagnosed cases of bacterial meningitis. Out of 308 samples 92 samples were culture positive (30.6%). Out of which 82 were bacterial culture,10 fungal cultures and 11 smears were AFB positive. | NR | 31.70% |
| Bhagawati et al.36 | 2009–2010 | East | 51 cases of meningitis | Newborn to >45 years | 4% |
| H. influenzae | |||||
| Chinchankar et al.55 | NS/2 years | West | 54 patients with ABM. Chief presentation was high fever,
refusal of feeds, altered sensorium and
seizures. • 26% of patients had meningeal signs. • 39% patients developed acute neurological complications during the hospital course. |
1 month–5 years | 26% (Hib) |
| Vashishtha56 | 2009–2010 | North | 67 patients with ABM Fever (91%), altered sensorium (62.7%), vomiting (50.8%), seizures (47.8%) and refusal of feeds (23.9%) were the most presenting features. |
41.5 (±26.9) months | 4.50% (Hib) |
| Chauhan et al.32 | NS/1 year | North | 81 ABM cases. Observed complications included seizures (23.4%), increased intracranial pressure (20.9%), infarct on imaging (4.9%), coma (4.9%), and respiratory compromise leading to ventilator support (3.7%) | 1–59 months | 6.10% (Hib) |
| Sankar et al.57 | 2002–2003 | North | 24 children with ABM | 2 months–12 years | 29.17% (Hib) |
| Pulickal et al.58 | NS/18 months | South | 80 children with ABM | NR | 5% (Hib) |
| Sahai et al.59 | 1994–1996 | South | 100 children with ABM | 1 month–12 years | 17% (Hib) |
| Shameem et al.61 | NS/48 months | South | 199 cases of meningitis | 1 month–3 years | 25.60% (Hib) |
| Jayaraman et al.13 | 2012–2013 | South | 257 cases of meningitis Male: female ratio in confirmed meningitis patients was 1.3:1 |
1–59 months | 14.40% (Hib) |
| Ramchandran et al.33 | 2008–2010 | Multiple states | 89 cases of bacterial meningitis | 1–23 months | 70% (Hib) |
| Mirdha et al.63 | 1988–1989 | North | 18 cases of bacterial meningitis | 1 month–60 years | 11.11% |
| Pandit et al.66 | 2002/10 months | South | 21 positive CSF samples for bacterial meningitis | 2–65 years | 19.04% |
| Mani et al.67 | 1996–2005 | South | CSF samples from 385 clinically suspected cases of pyogenic meningitis were analysed. Proof of infective agent was studied in 284 cases of meningitis | NR | 1.80% |
| Gangane and Doddamani41 | 2010–2012 | South | 308 CSF samples were collected from clinically diagnosed cases of bacterial meningitis. Out of 308 samples 92 samples were culture positive (30.6%). Out of which 82 were bacterial culture,10 fungal cultures and 11 smears were AFB positive. | NR | 3.60% |
| K. pneumoniae | |||||
| Debnath et al.28 | NS/21 years | West | 79 suspected cases of meningitis with majority of cases
(74.7%) under-five. 16 suspected cases of
meningitis. Male to female ratio was 1.82:1 |
Median age: 2.7 years | 31.2% |
| Vashishtha et al.56 | 2009–2010 | North | 67 patients with ABM Fever (91%), altered sensorium (62.7%), vomiting (50.8%), seizures (47.8%) and refusal of feeds (23.9%) were the most presenting features. |
41.5 (±26.9) months | 3.30% |
| Chauhan et al.32 | NS/1 year | North | 81 ABM cases. Observed complications included seizures (23.4%), increased intracranial pressure (20.9%), infarct on imaging (4.9%), coma (4.9%), and respiratory compromise leading to ventilator support (3.7%) | 1–59 months | 6.10% |
| Shameem et al.61 | NS/48 months | South | 199 cases of meningitis | 1 month–3 years | 4% |
| Devi et al.62 | 2013–2015 | East | 67 cases of neonatal meningitis | 12% | |
| Mirdha et al.63 | 1988–1989 | North | 18 cases of bacterial meningitis | 1 month–60 years | 5.50% |
| Raza et al.64 | 2015–2017 | North | 400 CSF samples of suspected HAM | NR | 10.42% |
| Srinivas et al.40 | 2001–2007 | South | 415 cases of post-operative meningitis (underwent neurosurgical procedures). The overall incidence of meningitis was 2.2%. The incidence of meningitis was high (7.7%) in patients who had a pre-existing infection like post-pyogenic meningitis ortuberculosis hydrocephalus. | NR | 12.53% |
| Gangane and Doddamani41 | 2010–2012 | South | 308 CSF samples were collected from clinically diagnosed cases of bacterial meningitis. Out of 308 samples 92 samples were culture positive (30.6%). Out of which 82 were bacterial culture,10 fungal cultures and 11 smears were AFB positive. | NR | 20.7% |
| Bhagawati et al.36 | 2009–2010 | East | 51 cases of meningitis | Newborn to >45 years | 15.70% |
| P. aeruginosa | |||||
| Vashishtha et al.56 | 2009–2010 | North | 67 patients with ABM Fever (91%), altered sensorium (62.7%), vomiting (50.8%), seizures (47.8%) and refusal of feeds (23.9%) were the most presenting features. |
41.5 (±26.9) months | 3.30% |
| Pulickal et al.58 | NS/18 months | South | 80 children with ABM | NR | 7.50% |
| Shameem et al.61 | NS/48 months | South | 199 cases of meningitis | 1 month–3 years | 1.50% |
| Devi et al.62 | 2013–2015 | East | 67 cases of neonatal meningitis | 9% | |
| Ramchandran et al.33 | 2008–2010 | Multiple states | 89 cases of bacterial meningitis | 1–23 months | 1.12% |
| Raza et al.64 | 2015–2017 | North | 400 CSF samples of suspected HAM | NR | 8.33% |
| Pandit et al.66 | 2002/10 months | South | 21 positive CSF samples for bacterial meningitis | 2–65 years | 4.76% |
| Srinivas40 | 2001–2007 | South | 415 cases of post-operative meningitis (underwent neurosurgical procedures). The overall incidence of meningitis was 2.2%. The incidence of meningitis was high (7.7%) in patients who had a pre-existing infection like post-pyogenic meningitis ortuberculosis hydrocephalus. | NR | 15.42% |
| Gangane and Doddamani41 | 2010–2012 | South | 308 CSF samples were collected from clinically diagnosed cases of bacterial meningitis. Out of 308 samples 92 samples were culture positive (30.6%). Out of which 82 were bacterial culture,10 fungal cultures and 11 smears were AFB positive. | NR | 9.70% |
| Bhagawati et al.36 | 2009–2010 | East | 51 cases of meningitis | Newborn to >45 years | 5.88% |
| S. aureus | |||||
| Vashishtha et al.56 | 2009–2010 | North | 67 patients with ABM Fever (91%), altered sensorium (62.7%), vomiting (50.8%), seizures (47.8%) and refusal of feeds (23.9%) were the most presenting features. |
41.5 (±26.9) months | 3.30% |
| Chauhan et al.32 | NS/1 year | North | 81 ABM cases. Observed complications included seizures (23.4%), increased intracranial pressure (20.9%), infarct on imaging (4.9%), coma (4.9%), and respiratory compromise leading to ventilator support (3.7%) | 1–59 months | 7.40% |
| Sankar et al.57 | 2002–2003 | North | 24 children with ABM | 2 months–12 years | 20.83% |
| Pulickal et al.58 | NS/18 months | South | 80 children with ABM | NR | 10% |
| Shameem et al.61 | NS/48 months | South | 199 cases of meningitis | 1 month–3 years | 5.50% |
| Mirdha et al.63 | 1988–1989 | North | 18 cases of bacterial meningitis | 1 month–60 years | 11.11% |
| Raza et al.64 | 2015–2017 | North | 400 CSF samples of suspected HAM | NR | 8.33% |
| Mital et al.65 | NS | North | 50 cases of pyogenic meningitis, 29 culture positive cases
of bacterial meningitis Male: female ratio of 5:1 |
15–70 years | 41.38% |
| Pandit et al.66 | 2002/10 months | South | 21 positive CSF samples for bacterial meningitis | 2–65 years | 4.76% |
| Mani et al.67 | 1996–2005 | South | CSF samples from 385 clinically suspected cases of pyogenic meningitis were analysed. Proof of infective agent was studied in 284 cases of meningitis | NR | 1.80% |
| Gangane and Doddamani41 | 2010–2012 | South | 308 CSF samples were collected from clinically diagnosed cases of bacterial meningitis. Out of 308 samples 92 samples were culture positive (30.6%). Out of which 82 were bacterial culture,10 fungal cultures and 11 smears were AFB positive. | NR | 7.30% |
| Bhagawati et al.36 | 2009–2010 | East | 51 cases of meningitis | Newborn to >45 years | 29.41% |
| E. coli | |||||
| Debnath et al.28 | NS/21 years | West | 79 suspected cases of meningitis with majority of cases
(74.7%) under-five. 16 suspected cases of
meningitis. Male to female ratio was 1.82:1 |
Median age: 2.7 years | 6.25% |
| Vashishtha et al.56 | 2009–2010 | North | 67 patients with ABM Fever (91%), altered sensorium (62.7%), vomiting (50.8%), seizures (47.8%) and refusal of feeds (23.9%) were the most presenting features. |
41.5 (±26.9) months | 7.50% |
| Chauhan et al.32 | NS/1 year | North | 81 ABM cases. Observed complications included seizures (23.4%), increased intracranial pressure (20.9%), infarct on imaging (4.9%), coma (4.9%), and respiratory compromise leading to ventilator support (3.7%) | 1–59 months | 6.10% |
| Shameem et al.61 | NS/48 months | South | 199 cases of meningitis | 1 month–3 years | 3% |
| Devi et al.62 | 2013–2015 | East | 67 cases of neonatal meningitis | 1.50% | |
| Raza et al.64 | 2015–2017 | North | 400 CSF samples of suspected HAM | NR | 27.08% |
| Pandit et al.66 | 2002/10 months | South | 21 positive CSF samples for bacterial meningitis | 2–65 years | 4.76% |
| Srinivas et al.40 | 2001–2007 | South | 415 cases of post-operative meningitis (underwent neurosurgical procedures). The overall incidence of meningitis was 2.2%. The incidence of meningitis was high (7.7%) in patients who had a pre-existing infection like post-pyogenic meningitis or tuberculosis hydrocephalus. | NR | 8.67% |
| Gangane and Doddamani41 | 2010–2012 | South | 308 CSF samples were collected from clinically diagnosed cases of bacterial meningitis. Out of 308 samples 92 samples were culture positive (30.6%). Out of which 82 were bacterial culture,10 fungal cultures and 11 smears were AFB positive. | NR | 12.10% |
| Bhagawati et al.36 | 2009–2010 | East | 51 cases of meningitis | Newborn to >45 years | 11.76% |
| N. meningitidis | |||||
| Chinchankar et al.55 | NS/2 years | West | 54 patients with ABM. Chief presentation was high fever,
refusal of feeds, altered sensorium and
seizures. • 26% of patients had meningeal signs. • 39% patients developed acute neurological complications during the hospital course. |
1 month–5 years | 1.85% |
| Vashishtha et al.56 | 2009–2010 | North | 67 patients with ABM Fever (91%), altered sensorium (62.7%), vomiting (50.8%), seizures (47.8%) and refusal of feeds (23.9%) were the most presenting features. |
41.5 (±26.9) months | 3% |
| Chauhan et al.32 | NS/1 year | North | 81 ABM cases. Observed complications included seizures (23.4%), increased intracranial pressure (20.9%), infarct on imaging (4.9%), coma (4.9%), and respiratory compromise leading to ventilator support (3.7%) | 1–59 months | 1.20% |
| Shameem et al.61 | NS/48 months | South | 199 cases of meningitis | 1 month–3 years | 6.00% |
| Jayaraman et al.13 | 2012–2013 | South | 257 cases of meningitis Male: female ratio in confirmed meningitis patients was 1.3:1 |
1–59 months | 2.70% |
| Devi et al.62 | 2013–2015 | East | 67 cases of neonatal meningitis | 2.70% | |
| Ramchandran et al.33 | 2008–2010 | Multiple states | 89 cases of bacterial meningitis | 1–23 months | 3%* |
| Mirdha et al.63 | 1988–1989 | North | 18 cases of bacterial meningitis | 1 month–60 years | 22.22% |
| Mital et al.65 | NS | North | 50 cases of pyogenic meningitis, 29 culture positive cases
of bacterial meningitis Male: female ratio of 5:1 |
15–70 years | 27.59% |
| Mani et al.67 | 1996–2005 | South | CSF samples from 385 clinically suspected cases of pyrogenic meningitis were analysed. Proof of infective agent was studied in 284 cases of meningitis | NR | 1% |
| Gangane and Doddamani41 | 2010–2012 | South | 308 CSF samples were collected from clinically diagnosed
cases of bacterial meningitis. Out of 308 samples 92 samples
were culture positive (30.6%). Out of which 82 were
bacterial culture,10 fungal cultures and 11 smears
were AFB positive. |
NR | 2.40% |
| Bhagawati et al.36 | 2009–2010 | East | 51 cases of meningitis | Newborn to >45 years | 4% |
^
Community-acquired cases.
*
Two from groups A, C, Y or W135, one isolate that was either Neisseria meningitidis group B or Escherichia coli K1.
ABM, acute bacterial meningitis; E. coli, Escherichia coli; NR, not reported; HAM, hospital-acquired meningitis; CSF, cerebrospinal fluid; H. influenzae, Hemophilus influenzae; Hib, Hemophilus influenzae type b; NS, not specified; P. aeruginosa, Pseudomonas aeruginosa; S. aureus, Staphylococcus aureus; S. pneumoniae, Streptococcus pneumoniae; K. pneumoniae, Klebsiella pneumoniae.