Antimicrobial sensitivity pattern of gram positive CSF isolates in children with septic meningitis in a Tertiary Care Hospital

Abstract

The present study was conducted with the objective to determine antimicrobial susceptibility of Gram positive CSF isolates in septic meningitis in a tertiary care hospital. CSF (3-5 ml) was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and microbial sensitivity was assessed by the Kirby-Bauer’s disk diffusion method. Of the samples tested 102 (15.99%) were culture positive of which 45 (44.12%) culture positives were found in children aged 1-12 years. M: F ratio was 1.62:1. Maximum incidence (51 cases) was in summer-rainy season and in institutional delivery (58 cases). Primary immunization did not protect against septic meningitis. The isolates in 66 (64.71%) cases were Gram positive of which 36 (54.55%) were Streptococcus spp., 24 (36.36%) Staphylococcus aureus and 6 (9.09%) cases coagulase negative Staphylococcus (CONS). Both Streptococci and coagulase negative Staphylococci were highly sensitive (100%) to Linezolid, Vancomycin and Piperacillin-Tazobactam. However, Staphylococcus aureus were 100% sensitive to Linezolid and Vancomycin but were only 87.5% sensitive to Piperacillin-Tazobactam combination. The Streptococcus species showed a high degree of resistance to Tetracyclin 91.67%, Co-trimoxazole 88.89% and Penicillin 63.89%. Staphylococcus aureus showed resistance to the tune of 83.33% each to Tetracycline and Co-trimoxazxole and 79.17% with Penicillin. In case of coagulase negative Staphylococcus, Co-trimoxazole showed resistance in 83.33%, Penicillin in 66.67% and Tetracycline in 50% cases. In septic meningitis Gram positive isolates predominate. Therapy should be based on trends of bacterial sensitivity.