DIVERSITY IN BACTERIAL ISOLATES WITH CHANGING ANTIBIOTIC SENSITIVITY PATTERN IN CASES OF MENINGITIS FROM A TERTIARY CARE HOSPITAL, INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 93
Abstract
BACKGROUND Isolation of atypical bacteria and evaluation of their antibiotic resistance pattern in cases of meningitis is of critical importance. AimsTo isolate and identify the bacteria causing meningitis in patients admitted in a tertiary care hospital, India. To evaluate the antimicrobial susceptibility pattern. MATERIALS AND METHODS Cerebrospinal fluid (CSF) and blood samples were collected from 83 clinically suspected patients suffering from meningitis. Direct smears were made from centrifuged CSF deposit and stained. Findings of Gram’s stain, Ziehl-Neelsen stain and negative stain were reported. Cultures on 5% sheep blood agar, MacConkey’s agar and chocolate agar were done. The supernatant was used for latex agglutination test (LAT). Antibiotic susceptibility tests were performed for all isolates. Statistical analysis was done by Standard statistical software package – SPSS (version 18). Study Design- Prospective observational study. Settings- This work was carried out in patients who suffered from meningitis and were admitted in a tertiary care hospital, India. Tests were conducted at Department of Microbiology & Central Laboratory in Katihar Medical College and Hospital, Bihar, India. Study Period- 2 years from 2009- 2011. RESULTS Out of 83 clinically suspected cases of meningitis, organisms were isolated from only 38 (45.8%) patients. Out of these 38 cases, one patient was suffering from meningitis along with ruptured meningocoele, and had dual infection with Providencia spp. and Citrobacter spp. making a total of 39 bacterial isolates. Most common organism isolated was Escherichia coli 25.6% (10/39), followed by Staphylococcus aureus 15.4% (6/39), Streptococcus pneumoniae 10.2% (4/39), Klebsiella species 10.2% (4/39) and Pseudomonas aeruginosa 10.2% (4/39). LAT detected bacterial antigens in 16.9% (14/38) cases. Antibiotic susceptibility pattern showed maximum in vitro activity against Gram-negative bacilli by imipenem, amikacin and chloramphenicol. Imipenem and chloramphenicol had best in vitro activity against Gram-positive cocci. Majority of strains showed resistance to 3rd generation cephalosporin. CONCLUSION The incidence of bacterial meningitis was more common with Gram-negative bacilli, Escherichia coli being the most common isolate. Established organisms of meningitis such as Haemophilus influenzae and Neisseria meningitidis were not isolated at all, despite all our efforts. All isolates were sensitive to imipenem, amikacin and chloramphenicol. All Gram-positive cocci were sensitive to imipenem with the increase in resistance to antibiotics like 3rd generation cephalosporin. Thus, chloramphenicol which is not in much use these days and penetrates well into the cerebrospinal fluid may prove to be an alternate drug for treatment of meningitis.
Authors and Affiliations
Partha Sarathi Chakrabarty, Moumita Adhikary
Keywords
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- EP ID EP279355
- DOI 10.14260/jemds/2017/1451
- Views 74
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