Received: December 23, 2010
Accepted: February 10, 2011
Ref: Chugh Y, Kapoor AK, Bhargava A. Antimicrobial sensitivity pattern of gram positive CSF isolates in children with septic meningitis in a tertiary care hospital. Internet J Med Update. 2011 Jul;6(2):30-9.
ANTIMICROBIAL SENSITIVITY PATTERN OF GRAM POSITIVE CSF ISOLATES IN CHILDREN WITH SEPTIC MENINGITIS IN A TERTIARY CARE HOSPITAL
Yashpal Chugh*, Arun Kumar Kapoor† and Anodita Bhargava‡
*Regional Medical Advisor, Astra Zeneca Pharma India Limited, New Delhi, India
†Head, Department of Pharmacology, Rohilkhand Medical College, Bareilly (UP), India
‡Associate Professor and Head, Department of Microbiology, M L N Medical College, Allahabad (UP), India
(Corresponding Author: Dr. Arun Kumar Kapoor, Department. of Pharmacology, Rohilkhand Medical College, Pilibhit Bypass Road, Bareilly, Uttar Pradesh, India; Cell: +919415373166; Email: email@example.com)
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-Bauerâ€™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.
KEY WORDS: Antimicrobial Sensitivity; Gram Positive Organisms; Cerebrospinal Fluid