Exploring risk factors, etiology, and clinical outcomes of acute bacterial meningitis in children under 7 years in Oman.

BACKGROUND: This study aimed to describe the bacterial profile, resistance characteristics, risk factors, and clinical outcomes of acute bacterial meningitis (ABM) in children treated at a secondary-care hospital in Oman. MATERIALS AND METHODS: In this descriptive, cross-sectional study, we evaluated 39 children aged 0-13 years who were diagnosed with ABM and admitted to our hospital between 2017 and 2023. Data on age, sex, risk factors, bacterial etiology, resistance characteristics, and clinical outcomes were retrieved from electronic health records. Statistical analyses included t-tests, Mann-Whitney tests, Chi-square tests, and Fisher's exact tests, with univariate odds ratios computed for infection correlations. RESULTS: The mean age of the participants was 12.9 months, with infections more prevalent among males (59%) and infants aged under 1 year (71.8%). Notable risk factors included neurosurgical intervention (36%), mechanical ventilation (26%), prematurity (23%), and low birth weight (23%). One-sixth of the children died from infection-related complications. Among survivors, neurological complications, including cognitive impairment (28%), seizures (26%), paralysis (13%), and mental disorders (10%), were common. E. coli and S. epidermidis were the most frequently isolated pathogens (17.9% each). All Gram-negative bacteria exhibited 100% susceptibility to carbapenems, whereas Gram-positive bacteria except MRSA have shown good susceptibility to beta-lactams antibiotics. MRSA strains are susceptible to ciprofloxacin and trimethoprim-sulfamethoxazole, and nearly all (5/6) E. coli isolates are extended-spectrum β-lactamase (ESBL) producers. CONCLUSION: ABMs remain a critical health concern in young children, particularly infants, with significant morbidity and mortality. Survivors often face neurological complications. Identifying risk factors, bacterial etiology, and antibiotic sensitivity patterns is essential for timely, effective treatment to reduce disease burden and improve outcomes.