Bacterial isolates and their antimicrobial resistance profile among patients presumptive for meningitis at a referral hospital, northwest Ethiopia

Abstract

Background: Bacterial meningitis remains as a major cause of mortality and morbidity in many developing countries, including Ethiopia. Data on the type and antimicrobial resistance profile of the isolates from cerebrospinal fluid (CSF) is limited in Ethiopia and particularly in the study area. Therefore, the aim of this study was to identify bacterial pathogens from CSF and to determine their antimicrobial resistance profile at Felege Hiwot Referral Hospital (FHRH).

Methods and Materials: A hospital-based cross-sectional study was conducted on 176 CSF samples collected from patients presumptive for meningitis at FHRH. Cerebrospinal fluid was collected by an experienced clinician aseptically and inoculated on blood, chocolate and MacConkey agars. Bacteriological culture and identification of the isolates was done following the conventional bacteriological procedure. Antimicrobial susceptibility testing (AST) was performed using the disk diffusion method. Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 23 for Windows. Descriptive statistics were used to present and summarize the findings.

Results: Of the 176 study participants, 112 (63.6%) were males and 70 (39.8%) were infants. The mean age of the study participants was at 14.3 years. Eight (4.5%) CSF samples were found bacteriological culture positive. Of these, gram-negative isolates accounted for five cases (62.5%), including three E. coli, and one case each of K. pneumoniae and P. aeruginosa. The remaining three isolates were S. aureus. In this study, the overall multi-drug resistance (MDR) rate was at 75%. Gentamicin and ciprofloxacin were found effective against S. aureus. Similarly, gram-negative isolates were found sensitive to ceftazidime and ceftriaxone.

Conclusions: In this study, the bacterial isolation rate from CSF was relatively low (4.5%). S. aureus, E. coli, K. pneumoniae and P. aeruginosa were identified and nearly one third of them were found to be multi-drug resistant which should be of concern to relevant stakeholders. A large-scale study is warranted. [Ethiop. J. Health Dev. 2020; 34(1):14-21]

Key words: Bacterial meningitis, Cerebrospinal fluid, types of bacterial isolates, antimicrobial resistance