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The most common cause of bacterial meningitis in children under five years of age is Haemophilus influenzae type b (Hib). This bacteria was historically a leading cause of serious infections, including meningitis, in this age group before the widespread use of the Hib vaccine. The vaccine has significantly reduced the incidence of Hib infections, but it remains a notable cause in unvaccinated populations or those who may not have received complete vaccination.

Streptococcus pneumoniae and Neisseria meningitidis are also significant pathogens that can cause meningitis in children, but in the context of children under five, Hib has been identified as the most common prior to the vaccine's introduction. Listeria monocytogenes primarily affects newborns and immunocompromised individuals, making it less common in the general pediatric population.

Understanding the role of vaccination programs and their impact on the prevalence of these bacteria is essential, as it changes the landscape of infections over time. The focus on Hib vaccination underscores the importance of preventive measures in public health.