Exploring the Etiological Profile and Sensitivity Pattern of Bacterial Pathogens Isolated from Cerebrospinal Fluid in Meningitis Patients: A Tertiary Care Center Study

Abstract

Objective: To explore the etiological profile and sensitivity pattern of bacterial pathogens isolated from cerebrospinal fluid (CSF) in meningitis patients at a tertiary care center. Study Design: Cross sectional study.Place and Duration of Study: The study was conducted at a tertiary care center, Lahore, Pakistan, from Jun 2021 to May 2022.Methodology: CSF samples obtained from hospitalized patients were processed according to standard microbiological protocols. Preliminary identification of pathogens was based on colony morphology, Gram staining, and biochemical testing. Gram-negative organisms were confirmed using API 10s. Antimicrobial susceptibility testing was performed using the standard Kirby Bauer disc diffusion method and interpretation was done according to CLSI guidelines (2023). E- Test method was used to determine the minimum inhibitory concentrations (MICs) of Penicillin and Vancomycin. Results: Out of 460 suspected cases, 94 (20.43%) were confirmed positive for meningitis. Streptococcal species were predominant among gram-positive organisms, while lactose fermenters, including E-coli dominated among gram-negative organisms. Lactose fermenters depicted poor sensitivity towards beta-lactams, extended generation cephalosporins and quinolones. Most of the non-lactose fermenters were sensitive to colistin.Conclusion: The study identified high prevalence rates of both gram-positive and gram-negative bacteria in CSF samples from bacterial meningitis. Additionally, low susceptibility to various tested drugs was observed. These findings emphasize the importance of accurate diagnosis and appropriate antibiotic management based on local antimicrobial resistance patterns, guiding antimicrobial stewardship and infection control practices.