Epidemiology, pathogen distribution, and comparative CSF profiles of viral and bacterial meningitis in South Lebanon: a six-year retrospective study
4 affiliations
- 1Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Beirut, Lebanon
- 2Faculty of Medicine, Lebanese University, Hadath-Beirut, Lebanon
- 3Medical laboratory and Blood Bank Department, Sheikh Ragheb Harb University Hospital, Nabatieh, Lebanon
- 4Faculty of Health Sciences, Al Maaref University, Beirut, Lebanon
Abstract
Background: Meningitis is a neuroinflammatory disease affecting the three protective layers surrounding the brain and spinal cord. This disease, mainly caused by bacterial and viral infections, is associated with various risk factors and manifests with several clinical outcomes depending on the type of pathogen. Therefore, this study aimed to analyze epidemiological trends and compare the clinical and CSF features that distinguish bacterial from viral meningitis in South Lebanon over six years (2020–2025).
Methods: We conducted a retrospective analysis of 473 records of patients with suspected meningitis, from 1st January 2020 to 30th September 2025. Data on CSF parameters were retrieved from patients’ medical records. CSF samples were collected at admission via lumbar puncture, and 100 cases met microbiological/CSF criteria for confirmed meningitis. Viral diagnosis relied on PCR panels, whilst bacterial diagnosis relied on PCR and culture. The Mann-Whitney U test was used to compare CSF component values among different groups, whilst Fisher’s exact test was used to assess the association between categorical variables.
Results: Viral meningitis predominated, with Enteroviruses being the leading viral agent (44 cases). S. pneumoniae accounted for 14 of 15 (93.3%) bacterial cases. A statistically significant correlation was observed between patients’ age groups and meningitis-causing agents. Patients’ age groups were statistically significantly correlated with different meningitis-causing viral categories, with the majority of cases occurring in children. In contrast, bacterial meningitis was more frequently observed among adolescents and adults. CSF parameters differed significantly between the two groups. Bacterial meningitis cases showed higher total WBC, neutrophil %, and protein levels, but lower glucose levels compared to viral meningitis cases.
Conclusions: Viral meningitis was substantially more prevalent than bacterial meningitis. CSF parameters were significantly associated with viral and bacterial infections. Identification of the causative pathogen and characterization of CSF profiles may facilitate earlier differentiation between viral and bacterial meningitis and support clinical decision-making.
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BibTeX
@article{fayyadkazan2026epidemiology,
title = {{Epidemiology, pathogen distribution, and comparative CSF profiles of viral and bacterial meningitis in South Lebanon: a six-year retrospective study}},
author = {Hussein Fayyad-Kazan and Fatima Kdouh and Fatima Shaalan and Malak Hammadi and Zahraa Tarhini and Sadek Hashem and Mahdi Tarhini},
journal = {BMC Public Health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28826-8},
url = {https://doi.org/10.1186/s12889-026-28826-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Epidemiology, pathogen distribution, and comparative CSF profiles of viral and bacterial meningitis in South Lebanon: a six-year retrospective study
AU - Hussein Fayyad-Kazan
AU - Fatima Kdouh
AU - Fatima Shaalan
AU - Malak Hammadi
AU - Zahraa Tarhini
AU - Sadek Hashem
AU - Mahdi Tarhini
PY - 2026
DA - 2026/08/07
JO - BMC Public Health
DO - 10.1186/s12889-026-28826-8
UR - https://doi.org/10.1186/s12889-026-28826-8
AB - Background: Meningitis is a neuroinflammatory disease affecting the three protective layers surrounding the brain and spinal cord. This disease, mainly caused by bacterial and viral infections, is associated with various risk factors and manifests with several clinical outcomes depending on the type of pathogen. Therefore, this study aimed to analyze epidemiological trends and compare the clinical and CSF features that distinguish bacterial from viral meningitis in South Lebanon over six years (2020–2025). Methods: We conducted a retrospective analysis of 473 records of patients with suspected meningitis, from 1st January 2020 to 30th September 2025. Data on CSF parameters were retrieved from patients’ medical records. CSF samples were collected at admission via lumbar puncture, and 100 cases met microbiological/CSF criteria for confirmed meningitis. Viral diagnosis relied on PCR panels, whilst bacterial diagnosis relied on PCR and culture. The Mann-Whitney U test was used to compare CSF component values among different groups, whilst Fisher’s exact test was used to assess the association between categorical variables. Results: Viral meningitis predominated, with Enteroviruses being the leading viral agent (44 cases). S. pneumoniae accounted for 14 of 15 (93.3%) bacterial cases. A statistically significant correlation was observed between patients’ age groups and meningitis-causing agents. Patients’ age groups were statistically significantly correlated with different meningitis-causing viral categories, with the majority of cases occurring in children. In contrast, bacterial meningitis was more frequently observed among adolescents and adults. CSF parameters differed significantly between the two groups. Bacterial meningitis cases showed higher total WBC, neutrophil %, and protein levels, but lower glucose levels compared to viral meningitis cases. Conclusions: Viral meningitis was substantially more prevalent than bacterial meningitis. CSF parameters were significantly associated with viral and bacterial infections. Identification of the causative pathogen and characterization of CSF profiles may facilitate earlier differentiation between viral and bacterial meningitis and support clinical decision-making.
SN - 1471-2458
ER -