Published in PLOS One on 2026-02-26, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Tadese Sisay, Daniel Mekonnen, Mitkie Wendmagegn, Ayenew Berhan, Addisu Melese
Source: PLOS One • DOI 10.1371/journal.pone.0342467
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Bacterial meningitis remains a major cause of morbidity and mortality among children in low-resource settings. Delayed diagnosis and antimicrobial resistance complicate effective management, and recent local data from Ethiopia are limited. This study aimed to determine the bacterial etiology and antimicrobial susceptibility patterns among children with suspected bacterial meningitis in Northwest Ethiopia. A hospital-based cross-sectional study was conducted from June 3 to December 25, 2024, among 189 pediatric patients aged 0–14 years who were clinically suspected of bacterial meningitis at two comprehensive specialized hospitals in Bahir Dar. Cerebrospinal fluid samples were collected aseptically and analyzed using standard cytological, biochemical, and microbiological methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method in accordance with CLSI M100 (34th edition, 2024) guidelines. Data were entered and analyzed using SPSS version 26, and descriptive statistics, including frequencies and 95% confidence intervals for bacterial prevalence, were computed. Of the 189 cerebrospinal fluid samples analyzed, 10/189 (5.3%) were culture positive. Gram-negative bacteria accounted for 6/10 (60%) of isolates. Escherichia coli and Staphylococcus aureus were the most frequently identified pathogens, each representing 3/10 (30%), followed by Klebsiella pneumoniae at 2/10 (20%). Most confirmed cases occurred in infants aged 1–12 months. Ceftriaxone and imipenem were fully susceptible in Staphylococcus aureus and Klebsiella pneumoniae, while resistance was highest to ampicillin in Escherichia coli (2/3, 66.7%) and to ciprofloxacin in Staphylococcus aureus (1/3, 33.3%). Multidrug resistance among bacterial isolates was uncommon, with MDR detected in a single Escherichia coli isolate (33.3%), while no MDR was observed in other pathogens. In conclusion, Gram-negative bacteria predominated among pediatric bacterial meningitis cases in Northwest Ethiopia. These findings highlight the need for ongoing surveillance, improved laboratory capacity, and evidence-based antimicrobial stewardship to guide empirical therapy and improve pediatric outcomes.
1. Introduction
Meningitis remains a major public health concern, particularly among children, due to its rapid clinical progression, high fatality rate, and risk of permanent neurological sequelae. Globally, more than 2.5 million new cases and over 236,000 deaths from bacterial meningitis are reported each year, with children under five years disproportionately affected. The disease imposes a significant burden on health systems, families, and communities, especially in low- and middle-income countries [1,2].
Children are particularly vulnerable due to immature immune defenses, increasing disease susceptibility and severity. Case fatality can reach 70% in low-resource settings, and survivors often experience long-term complications, including cognitive impairment, hearing loss, and motor deficits [3,4].
The etiology of bacterial meningitis varies by age and geographic setting. In preterm neonates, Escherichia coli and Group B Streptococcus are the most common pathogens, while term neonates and infants under three months are mainly affected by Group B Streptococcus, Escherichia coli, Streptococcus pneumoniae, and Listeria monocytogenes. In children aged three months to ten years, Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae predominate. Gram-negative bacteria are increasingly reported in resource-limited settings [5,6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Tadese Sisay, Daniel Mekonnen, Mitkie Wendmagegn, Ayenew Berhan, Addisu Melese. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Bacteriological profiles, antimicrobial resistance patterns, and predictors of culture-confirmed neonatal Sepsis at Asella Teaching Hospital, Southeast Ethiopia
- Evidence brief: Bacterial profile and antimicrobial resistance patterns of bloodstream infections at Amhara Public Health Institute, Bahir Dar, Ethiopia
- Evidence brief: Sepsis neonatorum: Bacterial profile, antimicrobial resistance patterns, among neonates and associated factors, Dilla University Referral Hospital, southern Ethiopia, with special reference to WHO prioritized pathogens
