Prevalence of Gram-negative Pathogens and their antimicrobial susceptibility in bacterial meningitis in pediatric cases

The present study was conducted to find out the prevalence and spectrum of Gram negative pathogens causing bacterial meningitis and their antimicrobial susceptibility pattern in a tertiary care hospital. The cerebrospinal fluid (CSF) (3-5 ml) was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and antimicrobial susceptibility was assessed by the Kirby-Bauer disk diffusion method. Of the 638 samples tested 102 (15.99%) were culture positive. Male to female (M:F) ratio was 1.62:1. The maximum incidence of 45(44.12%) cases was found in children (1-12 yrs); in institutional deliveries the incidence was 58 (56.86%) cases. Further, the incidence of 51 cases was found from May to August. Escherichia coli (E. coli) were commonest, seen in 9 (25%) cases followed by Acinetobacter spp., Citrobacter spp. and Klebsiella spp. with 6 (16.67%) cases each. Enterobacter spp., Neisseria spp. and Pseudomonas aeruginosa were isolated in 3 (8.33%) cases each. E. coli, Acinetobacter spp, Citrobacter spp and Klebsiella spp isolates were 100% susceptible to meropenem, piperacillin-tazobactam and cefoperazone-sulbactam and 100% resistant to cotrimoxazole and tetracycline. All strains of Neisseria spp, Enterobacter spp and Pseudomonas spp. were 100% susceptible to meropenem followed by gatifloxacin. These were 100% resistant to tetracycline and cotrimoxazole. Neisseria spp. were also 100% susceptible to pristinamycin. In septic meningitis Gram negative organisms are less common (35.29%). Of the isolates, more common Gram negative isolates included E. coli, Acinetobacter Spp., Citrobacter Spp., and Klebsiella spp. and these isolates were 100% susceptible to meropenem, piperacillin-tazobacatam and cefoperazone-sulbactam. Hence, empirical therapy should be formulated according to antimicrobial susceptibility patterns.