[Etiology and evolution of bacterial meningitis in a pediatric center]

OBJECTIVE: To establish the prevalence of the etiological agents of bacterial meningitis in a reference center for the treatment of infectious diseases in the state of Minas Gerais. METHODS: Descriptive study including all children with probable diagnosis of meningitis between June/1999 and November/1999. RESULTS: There were 210 cases of meningitis, and 111 (52.9%) were caused by bacteria. Actually, 52 were probable bacterial meningitis (with liquor alterations) and 59 were confirmed (with culture and/or antigen tests). The main agents were: Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. The initial treatment for children aged between three months and five years consisted of ampicillin and chloramphenicol. Later, the antibiotic was changed to penicillin in cases of Neisseria meningitidis and Streptococcus pneumoniae. and to chloramphenicol in cases of Haemophilus influenzae. Extended spectrum antimicrobial agents were used on clinical or laboratory basis, but resistant microorganisms were not found in cultures. CONCLUSIONS: The epidemiology of meningitis should be continuous and should consider local data in order to guide antimicrobial therapy. The continuous monitoring of the prevalent agents in each institution and their resistance is fundamental to the selection of antimicrobial drugs, preserving the antimicrobial agents, and causing less interference with individual colonization, without contributing to the increasing resistance of the agents responsible for meningeal infections.