Bacteria and Antibiotic Susceptibility Patterns of Cerebrospinal Fluid Isolated in Children with Bacterial Meningitis at Sanglah Hospital, Bali from 2016 to 2018
Clinical Neurology and Neuroscience
Volume 4, Issue 3, September 2020, Pages: 51-56
Received: Jun. 22, 2020;
Accepted: Jul. 14, 2020;
Published: Jul. 28, 2020
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Gina Henny Kristianti, Department of Child Health, Medical Faculty of Udayana University, Denpasar, Indonesia
I Gusti Ngurah Made Suwarba, Department of Child Health, Medical Faculty of Udayana University, Denpasar, Indonesia
Dewi Sutriani Mahalini, Department of Child Health, Medical Faculty of Udayana University, Denpasar, Indonesia
I Wayan Gustawan, Department of Child Health, Medical Faculty of Udayana University, Denpasar, Indonesia
I Made Gede Dwi Lingga Utama, Department of Child Health, Medical Faculty of Udayana University, Denpasar, Indonesia
Periodic review from laboratory about the pathogens causing the bacterial meningitis and its antimicrobial sensitivity test result is important to determine the most common etiology of meningitis, since they can be varied according to time, geography, and patient’s age. This study is a retrospective descriptive study. Affordable population in this study was children with positive cerebrospinal fluid culture results who were treated in Pediatric ward at Sanglah hospital, Denpasar from January 1st, 2016 until December 31st, 2018. The study used secondary data from the microbiology register in Clinical Microbiology Laboratory and medical record of Sanglah Hospital. This study employed total sampling method to collect samples. There were 52 samples that obtained in this study. Most of them were gram negative bacteria (53.8%). The most common gram negative bacteria found were Pseudomonas sp, with Pseudomonas stutzeri. The most common gram positive bacteria found were Staphylococcus sp, with Staphylococcus hemolitikus. Vancomycin, Linezolid and Tigecyclin have high sensitivity against gram positive bacteria. Carbapenem, aminoglycoside and fourth generation of cephalosporine still had high sensitivity against gram negative bacteria. About 26.9% of bacterias were multidrug resistant organisms (MDRO) and most of them (78.6%) were gram positive. Ceftriaxone as our empirical therapy has low sensitivity (30%) to gram positive bacteria and moderate sensitivity to gram negative bacteria (53.57%). Resistance to cephalosporin might be quite high in this particular clinical setting due to high number of MDRO. It should be taken into account before giving treatment for bacterial meningitis.
Gina Henny Kristianti,
I Gusti Ngurah Made Suwarba,
Dewi Sutriani Mahalini,
I Wayan Gustawan,
I Made Gede Dwi Lingga Utama,
Bacteria and Antibiotic Susceptibility Patterns of Cerebrospinal Fluid Isolated in Children with Bacterial Meningitis at Sanglah Hospital, Bali from 2016 to 2018, Clinical Neurology and Neuroscience.
Vol. 4, No. 3,
2020, pp. 51-56.
Chugh Y, Kastury N, Kapoor AK. Study of antimicrobial sensitivity pattern of Gram-positive CSF isolates among children suffering from septic meningitis in a tertiary care hospital. Journal, Indian Academy of Clinical Medicine. 2011. 12 (4): 274-82.
Sudharshan R, Reddy P, Neelima A. Pattern and antibiogram of bacterial meningitis in children at a tertiary care hospital. Journal of Scientific and Innovative Research. 2013; 2 (6): 1012-6.
Agrawal, S. Nadel, S. Acute Bacterial Meningitis in Infants and Children. Pediatr Drugs. 2011; 13 (6): 385-400.
Karou SD, Balaka A, Bamoke M, Tchelougou D, Assih M, Anani K, Agbonoko, Simpore J, de Souza C. Epidemiology and antibiotic resistance of bacterial meningitis in Dapaong, northern Togo. Asian Pac J Trop Med. 2012; 5 (11): 848-52.
Eldin K, Nageeb E, Saeed M, Elsayeb AA, Ibrahim SA. Pattern of bacterial meningitis in Sudanese children, Omdurman, Sudan. African journal of microbiology research. 2010; 4 (24): 2670-3.
Ceyhan M, Yidirim I, Balmer P, Borrow R, Dikici B, Turgut M, et al. 2008. A Prospective Study of Etiology of Childhood Acute Bacterial Meningitis, Turkey. Emerg Infect Dis. 2008; 14 (7): 1089-96.
Kim BN, Peri AM, Paterson DL. Ceftriaxon. In: Grayson ML, editor. Kucer’s The Use of Antibiotics 7th ed. Boca Raton: CRC Press; 2017. p. 464-529.
Başpınar EO, Dayan S, Bekçibaşı M, Tekin R, Ayaz C, Deveci Ö, Hoşoğlu S. Comparison of culture and PCR methods in the diagnosis of bacterial meningitis. Brazilian Journal of Microbiology. 2017: 48 (2); 232-6.
Brouwer MC, Tunkel AR, Van De Beek D. Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. Clinical Microbiology Reviews. 2010; 23 (3): 467-92.
Afifi S, Wasfy MO, Azab MA. Laboratory-based surveillance of patients with bacterial meningitis in Egypt (1998-2004). European Journal of Clinical Microbiology and Infectious Diseases. 2007; 26 (5): 331-40.
Wang Y, Guo G, Wang H. Comparative study of bacteriological culture and real imefluorescence quantitative PCR (RT-PCR) and multiplex PCR- ased reverse line blot (mPCR/RLB) hybridization assay in the diagnosis of bacterial neonatal meningitis. BMCPediatr. 2014; 14: 224-30.
Wu SM, Cordeiro BH, Harcourt. Accuracy of real-time PCR, Gram stain and culture for Streptococcus pneumoniae, Neisseriameningitidis and Haemophilus influenza meningitis diagnosis. BMC Infectious Diseases. 2013; 13 (1): 26.
Shrestha RG, Tandukar S, Ansari S, Subedi A, Shrestha A, Poudel R, Sherchand JB. Bacterial meningitis in children under 15 years of age in Nepal. BMC Pediatrics. 2015; 15 (1): 1-7.
Khater WS, Elabd SH. Identification of Common Bacterial Pathogens Causing Meningitis in Culture-Negative Cerebrospinal Fluid Samples Using Real-Time Polymerase Chain Reaction. International Journal of Microbiology, 2016, 17-19.
Mohammadi SF, Patil AB, Nadagir SD, Nandhihal N, Lakshminarnyana SA. Diagnostic value of latex agglutination test in diagnosis of acute bacterial meningitis. Ann Indian Acad Neurol. 2013; 16 (4): 645-9.
Mengistu A, Gaeseb J, Uaaka G, Ndjavera C, Kambyambya K, Indongo L, Sagwa E. Antimicrobial sensitivity patterns of cerebrospinal fluid (CSF) isolates in Namibia: Implications for empirical antibiotic treatment of meningitis. Journal of Pharmaceutical Policy and Practice. 2013; 6 (1): 1.
Murgas YG, Snowden JN. Ventricular shunt infections: Immunopathogenesis and clilnical management. J Neuroimmunol. 2014; 276 (0): 1-8.
Desai A, Lollis SS, Missios S, Radwan T, Zuaro DE, Schwarzman JD, Duhaime AC. How long should cerebrospinal fluid cultures be held to detect shunt infections? Clinical article. Journal of Neurosurgery: Pediatrics, 2009: 4 (2); 184-9.
Abdelkader MM, Aboshanab KM, El-Ashry MA, Aboulwafa MM. Prevalence of MDR pathogens of bacterial meningitis in Egypt and new synergistic antibiotic combinations. PLoS ONE, 2017; 12 (2): 1-20.
Jarousha AM, Afifi A. Epidemiology and risk factors associated with developing bacterial meningitis among children in Gaza strip. Iranian Journal of Public Health. 2014; 43 (9): 1176-83.
Huang CR, Lu CH, Wu JJ, Chang HW, Chien CC, Lei CB, Chang WN. Coagulase-negative staphylococcal meningitis in adults: Clinical characteristics and therapeutic outcomes. Infection. 2005; 33 (2): 56-60.
Bisharat N, Gorlachev T, Keness Y. 10-years hospital experience in Pseudomonas stutzeri and literature review. Open Infectious Diseases Journal. 2012; 6 (1): 21-24.
Thomas V, Riaz Ahmed S, Qasim S. Cerebro spinal fluid analysis in childhood bacterial meningitis. Oman Medical Journal. 2008; 23 (1): 32-3.
Berhe YH, Amaha ND, Ghebrenegus AS. Evaluation of ceftriaxone use in the medical ward of Halibet National Referral and teaching hospital in 2017 in Asmara, Eritrea: A cross sectional retrospective study. BMC Infectious Diseases. 2019: 19 (1), 1-7.