{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:52:07Z","timestamp":1783698727891,"version":"3.55.0"},"reference-count":38,"publisher":"Akademiai Kiado Zrt.","issue":"2","funder":[{"name":"Research and High Education Ministry of Tunisia","award":["LR18ES39"],"award-info":[{"award-number":["LR18ES39"]}]}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The worldwide burden of disease of bacterial meningitis remains high, despite the decreasing incidence following introduction of routine vaccination campaigns.<\/jats:p><jats:p>The aim of our study was to evaluate the epidemiological and bacteriological profile of paediatric bacterial meningitis (BM) in Tunisian children, during the period 2003\u20132019, following the implementation of <jats:italic>Haemophilus influenzae<\/jats:italic> type b (Hib) vaccine (April 2011) and before 10-valent pneumoccocal conjugate vaccine (PCV10) introduction to the childhood immunization program.<\/jats:p><jats:p>All bacteriologically confirmed cases of BM admitted to children's hospital of Tunis were recorded (January 2003 to April 2019). Serogroups of <jats:italic>Neisseria meningitidis<\/jats:italic> (Nm) and serotypes of <jats:italic>Streptococcus pneumoniae<\/jats:italic> (Sp) and <jats:italic>H. influenzae<\/jats:italic> (Hi) and antibiotic resistance were determined using conventional and molecular methods.<\/jats:p><jats:p>Among 388 cases, the most frequent species were Sp (51.3%), followed by Nm (27.5%) and Hi\u00a0(16.8%). We observed a significant decrease in Hi BM rate during the conjugated Hib vaccine use period (<jats:italic>P<\/jats:italic> &lt; 0.0001). The main pneumococcal serotypes were 14, 19F, 6B, 23F and 19A and the serotype coverage of PCV10, PCV13, PCV15 and PCV20 was 71.3 and 78.8%, 79.4 and 81.9% respectively. The\u00a0most frequent Nm serogroup was B (83.1%). Most Hi strains were of serotype b (86.9%). High levels of resistance were found: Sp and Nm to penicillin (respectively 60.1 and 80%) and Hi to ampicillin (42.6%). All meningococcal and Hi isolates were susceptible to third-generation cephalosporins and 7.2% of pneumococcal strains had decreased susceptibility to these antibiotics.<\/jats:p><jats:p>The Hib conjugate vaccine decreased the rate of BM. Sp dominated the aetiology of BM in children in Tunisia. Conjugate vaccines introducing decreases not only BM cases but also antimicrobial resistance.<\/jats:p>","DOI":"10.1556\/030.2024.02208","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T11:28:15Z","timestamp":1716290895000},"page":"148-154","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":3,"title":["Epidemiological and bacterial profile of\u00a0childhood meningitis in Tunisia"],"prefix":"10.1556","volume":"71","author":[{"given":"Sarra","family":"Dhraief","sequence":"first","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3312-8265","authenticated-orcid":true,"given":"Khaoula","family":"Meftah","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"},{"name":"Tunis El Manar University, Faculty of Medicine of Tunis, LR18ES39, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Mhimdi","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"},{"name":"Tunis El Manar University, Faculty of Medicine of Tunis, LR18ES39, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houyem","family":"Khiari","sequence":"additional","affiliation":[{"name":"Tunis El Manar University, Faculty of Medicine of Tunis, LR18ES39, Tunis, Tunisia"},{"name":"Department of Epidemiology and Biostatistics, Salah Azaiz Institute, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firas","family":"Aloui","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"},{"name":"Tunis El Manar University, Faculty of Medicine of Tunis, LR18ES39, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Borgi","sequence":"additional","affiliation":[{"name":"Tunis El Manar University, Faculty of Medicine of Tunis, LR18ES39, Tunis, Tunisia"},{"name":"Pediatric Intensive Care Unit, Children's Hospital Bechir Hamza of Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sondes","family":"Haddad-Boubaker","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institute Pasteur of Tunis, University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani","family":"Brik","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Menif","sequence":"additional","affiliation":[{"name":"Tunis El Manar University, Faculty of Medicine of Tunis, LR18ES39, Tunis, Tunisia"},{"name":"Pediatric Intensive Care Unit, Children's Hospital Bechir Hamza of Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amel","family":"Kechrid","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Bouafsoun","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanen","family":"Smaoui","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Children's Hospital Bechir Hamza of Tunis, Tunisia"},{"name":"Tunis El Manar University, Faculty of Medicine of Tunis, LR18ES39, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"Defeating meningitis by 2030: a global road map","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. Defeating meningitis by 2030: a global road map. World Health Organization; 2021. https:\/\/www.who.int\/publications\/i\/item\/9789240026407."},{"key":"B2","series-title":"Laboratory methods for the diagnosis of meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae: WHO manual","author":"World Health Organization & Centers for Disease Control and Prevention (U.S.)","year":"2011","unstructured":"World Health Organization & Centers for Disease Control and Prevention (U.S.). Laboratory methods for the diagnosis of meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae: WHO manual. 2nd ed. World Health Organization; 2011. https:\/\/apps.who.int\/iris\/handle\/10665\/70765."},{"key":"B3","series-title":"Int J Infect Dis","first-page":"101","article-title":"Implementation of a prospective study for enhancing surveillance of invasive bacterial infections in North Africa","volume":"115","author":"Smaoui H","year":"2022","unstructured":"Smaoui H, Tali-Maamar H, Zouhair S, Bouheraoua S, Mefteh K, Bouskraoui M, et\u00a0al. Implementation of a prospective study for enhancing surveillance of invasive bacterial infections in North Africa. Int J Infect Dis 2022; 115: 101\u20135. https:\/\/pubmed.ncbi.nlm.nih.gov\/34843957\/."},{"issue":"14","key":"B4","series-title":"N Engl J Med","first-page":"970","article-title":"Bacterial meningitis in the United States in 1995","volume":"337","author":"Schuchat A","year":"1997","unstructured":"Schuchat A, Robinson K, Wenger JD, Harrison LH, Farley M, Reingold AL, et\u00a0al. Bacterial meningitis in the United States in 1995. 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