BACTERIAL PROFILING AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN ACUTE BACTERIAL MENINGITIS PATIENTS AT A TERTIARY HOSPITAL IN PAKISTAN.
Main Article Content
Keywords
Meningitis, Bacterial, EPI, Immunized, Non-immunized
Abstract
Background: Bacterial meningitis is a life-threatening type of inflammation of the membranes (meninges), which surround and shield your brain and spinal cord. Bacterial meningitis can be fatal within hours, but most patients recover. However, lifelong impairments like learning difficulties, hearing loss, or brain damage may persist. Bacterial meningitis is particularly dangerous, with 1 in 6 cases resulting in death and 1 in 5 having serious side effects. Safe, affordable vaccinations are the best way to provide long-lasting protection.
Objectives: Study objectives are:
To isolate and characterize bacterial pathogens from CSF and determine the antimicrobial susceptibility profiling of the isolated bacteria.
Study Design and Setting: A cross-sectional study was conducted at the Paediatric Department of Chandka Medical College (CMC) Shaheed Mohatrma Benazir Bhutto Medical University (SMBBMU) Larkana during the period January 2019 to December 2021.
Materials and Methods: Cerebrospinal fluid (CSF) samples from 78 clinically suspected cases of acute bacterial meningitis were processed for isolation, identification, culture, and sensitivity. The data was analysed using SPSS version 20.
Results: A total of 78 patients suspected of having meningitis were included. Of these mean ages of 3.06±0.402 years (range 2 months–15 years), according to age group 2–12 months, children seemed more affected, while gender-wise, 46 (59%) were males and 32 (41%) were females. According to the EPI schedule, only 42 (53.8%) children were fully vaccinated.
The common clinical presentations were fever 72 (92.3%), fits 46 (58.97%), lethargy 39(50%), headache 26 (33.3%), disorientation 17(21.79%), and unconsciousness 15 (19.23%). Of the 78 CSF specimens, 17 (21.79%) had a positive bacterial culture, while the remaining samples exhibited no growth. On Gram stain, there were 13 (76.47%) cases of Gram positivity and 4 (23.52%) cases of Gram negativity. The common pathogens identified on CSF culture were Streptococcus pneumoniae in 5 (29.41%) followed by coagulase-negative staphylococci (CoNS) in 4 (23.52%) and Staphylococcus aureus in 4 (23.52%), while E. coli in 3 (17.64%) and H.influenzae 1(5.88%). Coagulase-negative Staphylococcus, Staphylococcus aureus and E. coli show higher resistance rates, while Streptococcus pneumoniae and H. influenza exhibit predominant sensitivity.
Conclusion: Acute bacterial meningitis primarily affects children under 1 year of age. CSF culture revealed both gram-positive and gram-negative bacteria, i.e., streptococcus pneumoniae, the most common pathogen in CSF culture. Coagulase-negative Staphylococcus, Staphylococcus aureus and E. coli show higher resistance rates, while Streptococcus pneumoniae and H. influenza exhibit predominant sensitivity.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Delijan Mugheri
PhD scholar at Institute of Microbiology Shah Abdul Latif University, Khairpur.
Muneer Ahmed Qazi
Associate professor at Institute of Microbiology, Faculty of Natural science, Shah Abdul Latif University, Khairpur 66020, Sindh, Pakistan.
Khurshed Ahmed Abbasi
Professor of Paediatrics, Gambat Institute of Medical Sciences Gambat.