Objective: To investigate the bacteriological and antibiotic susceptibility profile of cerebrospinal fluid specimens collected from the patients with suspected bacterial meningitis.
Methodology: This prospective, cross-sectional study was carried out in which the cerebrospinal fluid specimens were obtained by lumber puncture from the hospitalized patients with suspected bacterial meningitis from January to December 2019. The bacterial isolates were identified using microscopic observations and biochemical methods. Kirby-Bauer disc diffusion method was used for antibiotic susceptibility profiling of isolates.
Results: Out of 519 specimens, 105(20.23%) were positive, while 414(79.77%) were negative for any microbial growth. The most frequent isolates were Coagulase negative Staphylococcus spp (CoNS) (17.15%), Staphylococcus aureus (12.38%), Acinetobacter spp (17.14%), and Escherichia coli (9.52%), while species of Enterococcus, Streptococcus, Klebsiella, Pseudomonas, Proteus, Neisseria, and Haemophilus were also recovered. S. aureus isolates were resistant to penicillin (94.44%) and oxacillin (83.33%), while susceptible to linezolid, vancomycin, and amikacin. Similar observations were obtained from CoNS isolates. For E. coli, amikacin and meropenem remained effective with 80.0% and 60.0%, respectively. Importantly, 50% of Acinetobacter spp isolates were resistant to all the five antibiotics tested.
Conclusion: The pathogens causing bacterial meningitis appeared resistant to the commonly used antibiotics while linezolid remained the most effective for Gram-positive isolates. However, antibiotic resistance in Gram-negative isolates seems alarming and informs the need of antibiotic stewardship at Pakistan.
Key words: Bacterial meningitis, Staphylococcus aureus, Neisseria meningitidis, antibiotics.
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