Etiological agents and their antibiotic resistance pattern isolated from cerebrospinal fluid (CSF) samples obtained from admitted patients in Lahore General Hospital (LGH), Lahore.

Abstract

Objective: To determine the most common etiological agent and their antibiotic resistance pattern in CSF samples obtained from admitted patients in neurosurgical wards in LGH, Lahore
Methods: It was a descriptive cross sectional study performed in Microbiology section of Pathology Department of Post Graduate Medical Institute (PGMI), Lahore during October 2015 to April 2017. The CSF specimens were inoculated on Blood agar and Mac Conkey agar plates and were incubated at 35 37°C aerobically. After 24 hours of incubation, the plates were examined for the presence of bacterial colonies. Organisms were identified by standard microbiological methods. Antibiotic sensitivity test was conducted employing the modified Kirby-Bauer disc diffusion method according to CLSI 2016.
Results: Out of 511 CSF culture samples, 137 (26.81%) were culture positive and 374 (73.18%) were culture negative. Among culture positive samples, the meningitis due to Acinetobacter spp and Pseudomonas spp account for 39 (28%) and 32 (23.02%) of the cases. Non fermentor gram negative rods are most resistant to Doxycycline and most sensitive to Pipercillin Tazobactam. Themeningitis caused by E.coli and Klebsiella spp are responsible for 12 (8.7%) and 16 (11.6%) cases of meningitis. The lactose fermentors are most resistant to Ampicillin and most sensitive to Imipenem. Staphylococci were 30(21.8%), most of the Staphylococci were Methicillin resistant Staphylococci (MRSA) and most were sensitive to Vancomycin and Linezolid. There are two cases of Streptococcus pneumonia and Ralstonia picketti and one case each of Ochrobactrum anthropi, Pasteurella spp, Vibrio metschnikovii, Aeromonas hydrophila and Chromobacterium violaceum.
Conclusions: TBacterial meningitis caused by gram negative bacilli is most common in our setup. Gram positive bacteria are most resistant to Penicillins and most sensitive to Vancomycin and Linezolid. The lactose fermenter gram negative rods are most resistant to Ampicillin and most sensitive to Imipenem. Non fermenter gram negative rods are most resistant to Doxycycline and most sensitive to Pipercillin Tazobactam.