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A cross-sectional study of etiological and sensitivity profiling of meningitis in under-five children
Tanushree Gahlot1, Dimple Kasana1
1Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Objectives:
The study aimed to understand the organism spectrum and antibiotic sensitivity profile of acute bacterial meningitis in pediatric population.
Methods:
A cross-sectional study was conducted at the department of microbiology of a tertiary care center for a period of 18 months. Suspected cases of meningitis between 1 and 60 months of age were considered for the study. All cases underwent cerebrospinal fluid tap for direct microscopy (DM), Gram staining, and culture sensitivity.
Results:
The mean age of the study patients was 10.42 months, with 61.7% of males and 38.3% of females. DM and culture were positive in 22.90% and 28.00% of the patients, respectively. On Gram stain, there were 29 (59.18%) cases of Gram positivity and 20 (40.82%) cases of Gram negativity. The culture growth showed that Acinetobacter spp. was isolated in 15 (30.6%) of the cases. Enterococcus spp. was isolated in 9 (18.4%) of the cases. Klebsiella pneumoniae was isolated in 8 (16.3%) of the cases. Staphylococcus aureus was isolated in 8 (16.3%) of the cases. Enterobacter spp. was isolated in 3 (6.12%) of the cases. Pseudomonas aeruginosa was isolated in 3 (6.12%) of the cases. Streptococcus pneumoniae was isolated in 3 (6.1%) of the cases. The antibiogram of different agents showed wide variation, with colistin being 100% sensitive for Acinetobacter, Enterobacter, K. pneumoniae, and P. aeruginosa.
Conclusion:
The present study revealed that Acinetobacter, Enterococcus, K. pneumoniae, and S. aureus were the most common bacterial etiologic agents of ABM. The 100% antibiotic sensitivity of the organisms to some antibiotics may suggest the use of such antibiotics while awaiting for culture sensitivity reports.
Insights
This study identified common bacteria causing acute bacterial meningitis in children, including Acinetobacter and Enterococcus. Colistin showed 100% sensitivity against several key pathogens, guiding empirical treatment.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Bacteriology
Background:
- Acute bacterial meningitis (ABM) remains a significant cause of morbidity and mortality in children.
- Understanding the local spectrum of causative organisms and their antibiotic susceptibility is crucial for effective management.
Purpose of the Study:
- To determine the spectrum of bacterial organisms responsible for ABM in pediatric patients.
- To analyze the antibiotic sensitivity profiles of isolated pathogens.
Main Methods:
- A prospective cross-sectional study was conducted over 18 months.
- Cerebrospinal fluid samples from children aged 1-60 months with suspected meningitis were analyzed using direct microscopy, Gram staining, and culture sensitivity.
- Organism identification and antibiotic susceptibility testing were performed.
Main Results:
- Acinetobacter spp. (30.6%), Enterococcus spp. (18.4%), Klebsiella pneumoniae (16.3%), and Staphylococcus aureus (16.3%) were the most frequently isolated bacteria.
- Colistin demonstrated 100% sensitivity against Acinetobacter spp., Enterobacter spp., K. pneumoniae, and Pseudomonas aeruginosa.
- Direct microscopy and culture were positive in 22.9% and 28.0% of cases, respectively.
Conclusions:
- Acinetobacter, Enterococcus, K. pneumoniae, and S. aureus are predominant pathogens in pediatric ABM.
- High in vitro sensitivity to certain antibiotics, like colistin for specific Gram-negative bacteria, supports their empirical use pending culture results.
