Detection of Enterobacteriaceae in cerebrospinal fluid fluid of neonates with meningitis from tertiary care hospitals

Eur Rev Med Pharmacol Sci. 2023 Nov;27(21):10563-10568. doi: 10.26355/eurrev_202311_34334.

Abstract

Objective: This study aimed to determine the bacteriological profile of childhood acute bacterial meningitis in Pakistan.

Patients and methods: The study included a total of 100 children aged between 1 month and 5 years, who were admitted with a diagnosis of meningitis based on clinical findings and positive cerebrospinal fluid (CSF) tests. Out of the 100 CSF samples collected, 21 isolates were confirmed to contain Enterobacteriaceae. The most prevalent Enterobacteriaceae species were Pseudomonas (n=8, 38.09%), Klebsiella (n=4, 19.04%), E. coli (n=4, 19.04%), and Acinetobacter (n=4, 19.04%), while Citrobacter (n=1, 4.76%) was less common. Antibiotic susceptibility patterns were analyzed for these isolates.

Results: Pseudomonas (n=8) exhibited 25% resistance to cefepime and 38% resistance to imipenem. Klebsiella (n=4) showed 75% resistance to imipenem. Acinetobacter (n=4) demonstrated 50% resistance to imipenem, along with varying resistance to cefepime, amikacin, ciprofloxacin, and gentamicin. E. coli (n=4) showed 0% resistance to imipenem and amikacin. However, Citrobacter (n=1) showed 0% resistance to ciprofloxacin, aztreonam, gentamicin, amikacin, levofloxacin, and cefepime. Acute bacterial meningitis primarily affects children under 1 year of age.

Conclusions: CSF culture revealed that Gram-negative bacteria, specifically Pseudomonas spp., were the predominant pathogens in this family based on Pakistani data.

MeSH terms

  • Amikacin
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Cefepime
  • Child
  • Ciprofloxacin
  • Drug Resistance, Bacterial
  • Enterobacteriaceae
  • Escherichia coli
  • Gentamicins
  • Gram-Negative Bacteria
  • Humans
  • Imipenem
  • Infant
  • Infant, Newborn
  • Meningitis, Bacterial* / diagnosis
  • Meningitis, Bacterial* / drug therapy
  • Microbial Sensitivity Tests
  • Tertiary Care Centers

Substances

  • Anti-Bacterial Agents
  • Cefepime
  • Amikacin
  • Imipenem
  • Ciprofloxacin
  • Gentamicins