Received: December 19, 2011
Accepted: April 18, 2012
Chugh YP, Kapoor AK, Bhargva A. Prevalence of Gram-negative Pathogens and their antimicrobial susceptibility in bacterial meningitis in pediatric cases. Internet J Med Update. 2012 Jul;7(2):32-41.


Yash Pal Chugh*, A. K. Kapoor** and Anodia Bhargava***

*Regional Medical Advisor, Astra Zeneca Pharma India Ltd, New Delhi, India
**Professor and Head, Department of Pharmacology, Rohilkhand Medical College, Bareilly (UP), India
***Associate Professor and Head, Department of Microbiology, MLN Medical College, Allahabad (UP), India

(Corresponding Author: Professor A K Kapoor, Head, Department of Pharmacology, Rohilkhand Medical College, Bareilly (UP), India; Cell: +919415373166; Email:


The present study was conducted to find out the prevalence and spectrum of Gram negative pathogens causing bacterial meningitis and their antimicrobial susceptibility pattern in a tertiary care hospital. The cerebrospinal fluid (CSF) (3-5 ml) was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and antimicrobial susceptibility was assessed by the Kirby-Bauer disk diffusion method. Of the 638 samples tested 102 (15.99%) were culture positive. Male to female (M:F) ratio was 1.62:1. The maximum incidence of 45 (44.12%) cases was found in children (1-12 yrs); in institutional deliveries the incidence was 58 (56.86%) cases. Further, the incidence of 51 cases was found from May to August. Escherichia coli (E. coli) were commonest, seen in 9 (25%) cases followed by Acinetobacter spp., Citrobacter spp. and Klebsiella spp. with 6 (16.67%) cases each. Enterobacter spp., Neisseria spp. and Pseudomonas aeruginosa were isolated in 3 (8.33%) cases each. E. coli, Acinetobacter spp, Citrobacter spp and Klebsiella spp isolates were 100% susceptible to meropenem, piperacillin-tazobactam and cefoperazone-sulbactam and 100% resistant to cotrimoxazole and tetracycline. All strains of Neisseria spp, Enterobacter spp and Pseudomonas spp. were 100% susceptible to meropenem followed by gatifloxacin. These were 100% resistant to tetracycline and cotrimoxazole. Neisseria spp. were also 100% susceptible to pristinamycin. In septic meningitis Gram negative organisms are less common (35.29%). Of the isolates, more common Gram negative isolates included E. coli, Acinetobacter Spp., Citrobacter Spp., and Klebsiella spp. and these isolates were 100% susceptible to meropenem, piperacillin-tazobacatam and cefoperazone-sulbactam. Hence, empirical therapy should be formulated according to antimicrobial susceptibility patterns.

KEY WORDS: Gram negative organisms; Antimicrobial susceptibility; Cerebrospinal fluid