Abstract
Meningitis is an inflammatory infection of the membranes surrounding the brain and spinal cord, which occurs either as a primary disease or secondarily to disease in some other parts of the body. Its most frequent causes are Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. The epidemiological trend of acute meningitis varies with time and geography. Information on the relative frequency of the isolation and antibiotic susceptibility patterns of these pathogens is scarce in Nepal. To analyze the various causative agents of meningitis in all age group patients and to know the antimicrobial susceptibility pattern of bacterial isolates from the Cerebrospinal Fluids (CSF) of suspected cases of meningitis, were the prime objectives of this paper. In this cross sectional study, a total 356 CSF specimens were collected from patients suspected of meningitis and processed macroscopically, microscopically and microbiologically by standard microbiological methods in Emergency Laboratory of Tribhuvan University Teaching Hospital (TUTH) Kathmandu, Nepal over a period of six months, from March to August 2014. Out of 356 CSF samples, 16(4.5%) were found to be culture positive. Among the culture positive isolates, the most common bacterial isolate was Staphylococcus aureus, 4(25%). Isolation rate of Cryptococcus neoformans, the only fungal etiology of meningitis, was 3(18.8%), which was seen in elderly patients indicating increased susceptibility of C. neoformans in immune-compromised status of patients. All bacterial isolates were found to be sensitive to Chloramphenicol. The isolation rate of pathogens causing meningitis from CSF is low (4.5%). Chloramphenicol may be used for the treatment of bacterial meningitis.
Highlights
Meningitis is one of the medical emergencies related to infectious diseases, which is potentially associated with a high rate of complications
Of the 16 culture positive cases, bacterial pathogens were isolated in 13(81.3%) cases whereas C. neoformans was the only fungal isolate isolated in 3(18.8%) cases
The incidence of meningitis was not found to be statistically significant (p>0.05) with the age groups (≤14 and >14 years) and across the sex of the patients included in this study (p>0.05) (Table 1)
Summary
Meningitis is one of the medical emergencies related to infectious diseases, which is potentially associated with a high rate of complications. The term Meningitis is used to describe an inflammation of the membranes that surround the brain or the spinal cord. There is paucity of objective data on the causative agents of meningitis and their susceptibility in Nepalese population (Ansari and Pokhrel, 2011). Due to the urgency associated with the treatment of meningitis, there is, the need to have knowledge of the causative agents and their susceptibility profiles to come to better decisions of the empirical treatment. The aim of this paper is to analyze the etiology of meningitis and to determine the antibiotic susceptibility
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