Etiology of Acute Bacterial Meningitis in Iran: a Systematic Review

Acute bacterial meningitis (ABM) is one of the most severe infectious diseases, causing<br />neurologic sequel, and a case fatality rate of 20-30%. The aim of this paper was to summarize the main<br />causes of ABM in Iran. We searched the data for relevant articles using meningitis, etiology, and Iran as<br />search terms. We found 23 papers for inclusion in the review that focused specifically on the ABM,<br />addressing etiology and acute meningitis. Finally, during the 23 years, a total of 18163 cases were recorded,<br />and 1074 cases of which met the criteria for bacterial meningitis. The most common agent associated with<br />bacterial meningitis was S. pneumoniae, followed by H. influenzae, Enterobacter spp., N. meningitidis, and<br />group B streptococcus. The total incidence of ABM during 1991 to 2002 was higher than during 2003-2013.<br />S. pneumoniae still remains a main cause of bacterial meningitis. For improved outcomes, studies are<br />needed to further clarify the etiology of meningitis in Iran, explore simple, accurate, and practical diagnostic<br />tools as PCR, and investigate the most appropriate specific and supportive interventions to manage and<br />prevent meningitis as vaccination