Aetiology and Antimicrobial Resistance Patterns of Bacterial Meningitis in Adults Patients Admitted at Parirenyatwa Group of Hospitals from January 2023 to December 2024

Abstract

Background: Meningitis is a significant cause of morbidity and mortality, particularly among HIV patients. While cryptococcal meningitis is more commonly recognized in Zimbabwe, bacterial meningitis (BM) remains underdiagnosed and is often missed in cerebrospinal fluid (CSF) cultures due to limited diagnostic capacity. The recent acquisition of a PCR-based BioFire system at Parirenyatwa Hospital promises to transform CSF processing and provide clearer insights into BM. Methodology: This retrospective cross-sectional study evaluated 447 CSF samples collected at Parirenyatwa Hospital between January 2023 and December 2024. The BioFire system was employed for meningitis syndromic testing to identify bacterial pathogens responsible for BM. Results: BM was confirmed in 7.8% of the samples. Streptococcus pneumoniae was the predominant pathogen, accounting for 54.2% of cases, followed by Neisseria meningitidis (28.9%), Haemophilus influenzae (11.4%), Streptococcus agalactiae (2.9%), and Escherichia coli (2.9%). Demographic analysis revealed that the highest incidence occurred in the 18–29-year age group, likely reflecting increased exposure in crowded settings, while older adults, despite being a larger part of the study population, exhibited a lower incidence. No statistically significant gender differences were observed. Seasonally, BM cases peaked in March during Zimbabwe’s dry season, a time when environmental conditions favor pathogen transmission. Antimicrobial susceptibility testing showed high efficacy for penicillin (94%), ampicillin (91%), and ceftriaxone (88%), whereas meropenem exhibited a lower susceptibility rate (75%), suggesting emerging resistance trends. Conclusion: Although the overall prevalence of BM in this setting is lower compared to regions within the African meningitis belt, the study highlights important age-related trends, seasonal variations, and evolving antimicrobial resistance. These findings emphasize the urgent need for increased focus on Bacterial cultures diagnosis in CSF for laboratories that do not have PCR and targeted public health interventions to improve BM management in resource-limited settings.