Clinical, Microbiological Characteristics and Predictors of Positive Cerebrospinal Fluid Culture Among Neonates with Suspected Meningitis in Kano, Nigeria: A Cross-Sectional Study

Authors

  • Surayya Lawan Idris Department of Biological Sciences, Northwest University Kano
  • Nasir Tukur Dabo Department of Biological Sciences, Bayero University Kano
  • Abdulkadir M Magashi Department of Microbiology, Bayero University Kano
  • Auwalu Halliru Arzai Department of Microbiology, Bayero University Kano
  • Nasiru Murtala Doguwa Haematology Laboratory, Aminu Kano Teaching Hospital
  • Amina Ibrahim Influenza Diagnostic Laboratory, Aminu Kano Teaching Hospital
  • Zubaida Ladan Farouk Department of Paediatrics, Bayero University Kano, Kano, Nigeria/ Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria

Keywords:

Bacteria, neonatal meningitis, latex agglutination, 16S rRNA sequencing, antimicrobial resistance, Prematurity

Abstract

Background:
Neonatal meningitis is a significant cause of mortality and morbidity in sub-Saharan Africa, and there is a dearth of data regarding its causes and diagnostic challenges. The aim of this research was to assess the clinical and microbiological characteristics of neonatal meningitis and to identify factors that predict a positive cerebrospinal fluid (CSF) culture in newborns suspected of having meningitis in Kano.


Methods:

The hospital-based cross-sectional study enrolled 210 neonates with suspected meningitis at Aminu Kano Teaching Hospital and Murtala Muhammed Specialist Hospital. CSF samples of the enrollees were analyzed using conventional culture, latex agglutination, and 16S rRNA gene sequencing. Clinical and demographic data were collected using structured questionnaires. Multivariable logistic regression was performed to identify independent predictors of positive CSF culture.

Results:

The culture positivity rate was low at 3.3%, with Streptococcus pneumoniae and Haemophilus influenzae as the predominant pathogens. Latex agglutination demonstrated higher sensitivity at 13.8%, detecting mixed infections and in a setting with prior antibiotic exposure. Molecular sequencing identified atypical organisms including Pantoea ananatis and Acinetobacter baumannii, but percentage identities of matches (96.5% and 93.5%, respectively) was low. Turbid CSF appearance (aOR: 8.25, 95% CI: 0.85–79.94, p=0.069) and positive latex agglutination (aOR: 0.05, 95% CI: 0.004–0.499, p=0.012) were identified as predictors of culture positivity. Antimicrobial resistance to ceftriaxone, ciprofloxacin, and amikacin was prevalent. Despite high hospital delivery rates (91%), a notable proportion of preterm neonates (55.6% of cases) had meningitis. Conclusion: This study demonstrated the usefulness of rapid diagnostics in resource-limited settings. We recommend enhanced surveillance to address emerging pathogens and multidrug resistance.

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Published

2026-09-01

Issue

Vol. 5 No. 1 (2026): Journal of Perinatal and Neonatal Care (NJPNC)

Section

Articles