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Antibiotic resistance and bacterial spectrum in cerebrospial fluid cultures: Initial insights from Pakistan
Zafar Mehmood1, Noman Asghar2, Ihtisham Ullah1
1Department of Neurology, Lady Reading Hospital Medical Teaching Institution, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Abstract:
Antimicrobial resistance (AMR) is a rising global health concern, especially in resource-limited countries like Pakistan, where indiscriminate and unregulated use of antibiotics has significantly worsened this problem. The study aimed to analyze the bacterial spectrum and antimicrobial resistance patterns in cerebrospinal fluid (CSF) cultures from patients with suspected bacterial meningitis, providing crucial insights for better infection control and treatment strategies.This retrospective study analyzed 1107CSF cultures were between 2019 and 2024 at the Lady Reading Hospital, MTI, Khyber Pakhtunkhwa, Pakistan, to assess bacterial profiles in patients with suspected bacterial meningitis and investigate the AMR patterns. Among the 106 positive growth cultures, gram-negative bacteria accounted for 84.9 %. Alarmingly, Acinetobacter baumannii was found to be completely resistant to all the nine antibiotics tested, while Salmonella typhi showed resistance to six out of seven tested antibiotics, highlighting their severe multi-drug resistance profile. Moreover, notable resistance was observed in Citrobacter freundii, Enterobacter species, and Staphylococcus aureus. The distribution results indicated that the Klebsiella pneumoniae is more prevalent in males and the 1-13 years age group. These findings highlight the necessity for urgent action on antibiotic stewardship, improved surveillance, and public awareness to mitigate the spread of AMR pathogens, particularly in life-threatening infections such as bacterial meningitis. Strengthening infection control measures and regulating antibiotic usage policies is imperative to curb the growing AMR crisis.
Insights
Antimicrobial resistance (AMR) is a growing threat, particularly in Pakistan. This study reveals alarming resistance in bacterial meningitis pathogens, necessitating urgent antibiotic stewardship and infection control measures.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) poses a significant global health challenge, exacerbated in resource-limited settings like Pakistan due to antibiotic misuse.
- Bacterial meningitis remains a critical threat, demanding effective treatment strategies informed by local resistance patterns.
Purpose of the Study:
- To analyze the bacterial spectrum and antimicrobial resistance (AMR) patterns in cerebrospinal fluid (CSF) cultures from patients with suspected bacterial meningitis in Pakistan.
- To provide data for improved infection control and treatment strategies against meningitis pathogens.
Main Methods:
- A retrospective analysis of 1107 CSF cultures from 2019-2024 at Lady Reading Hospital, MTI, Khyber Pakhtunkhwa, Pakistan.
- Identification of bacterial isolates and assessment of their resistance profiles against various antibiotics.
Main Results:
- Gram-negative bacteria constituted 84.9% of the 106 positive cultures.
- Acinetobacter baumannii exhibited complete resistance to nine tested antibiotics; Salmonella typhi showed resistance to six of seven antibiotics.
- Significant resistance was also noted in Citrobacter freundii, Enterobacter species, and Staphylococcus aureus. Klebsiella pneumoniae was more prevalent in males and the 1-13 years age group.
Conclusions:
- The study highlights a severe multi-drug resistance profile among key meningitis pathogens in Pakistan.
- Urgent interventions including antibiotic stewardship, enhanced surveillance, and public awareness are crucial to combat AMR.
- Strengthening infection control and regulating antibiotic policies are imperative to mitigate the AMR crisis in bacterial meningitis.
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