STAPHYLOCOCCUS AUREUS MENINGITIS AMONG PAEDIATRIC EMERGENCIES IN A TERTIARY CENTER IN NIGERIA USING MOLECULAR METHODS

Abstract

Background: Bacterial meningitis remains a major cause of morbidity and mortality in children, particularly in low- and middle-income countries. While Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b were tradionally the most common pathogens, Staphylococcus aureus is increasingly being reported as a cause of paediatric meningitis in sub-Saharan Africa. This study aimed to determine the burden of S. aureus meningitis among children presenting with fever and central nervous system (CNS) signs at the University College Hospital, Ibadan, Nigeria, using molecular diagnostic methods. Methods: A prospective study was conducted among 98 consecutively admitted children aged one week to nine years with fever and CNS features. Cerebrospinal fluid (CSF) samples were analysed using Gram stain, culture, and a two-step molecular biology workflow: broad bacterial detection via 16S rRNA PCR, followed by specific PCR targeting S. aureus. Results: There 98 participants, 57(58.2%) males and 41(41.8%) females, aged one week to 9 years, of the 98 CSF samples tested, bacteria DNA was in 19 (19.4%). Among these, 7(7.1%) were positive for S. aureus. All S. aureus cases occurred in children older than one year, with a slight female predominance (57.1%). Seizures (84.7%) and lethargy (70.4%) were the most common presenting features. Two of the 7 who had S. aureus detected in their CSF were malnourished. Bacteria was not detected by CSF microscopy or culture. Conclusion: This study highlights a notable incidence of S. aureus meningitis among paediatric emergencies in Nigeria, accounting for nearly one-third of confirmed bacterial meningitis cases. The findings underscore the importance of incorporating molecular diagnostics into routine practice to improve detection and guide timely antimicrobial therapy.