Bacteria and Antibiotic Susceptibility Patterns of Cerebrospinal Fluid Isolated in Children with Bacterial Meningitis at Sanglah Hospital, Bali from 2016 to 2018

Abstract

Periodic review from laboratory about the pathogens causing the bacterial meningitis and its antimicrobial sensitivity test result is important to determine the most common etiology of meningitis, since they can be varied according to time, geography, and patient’s age. This study is a retrospective descriptive study. Affordable population in this study was children with positive cerebrospinal fluid culture results who were treated in Pediatric ward at Sanglah hospital, Denpasar from January 1st, 2016 until December 31st, 2018. The study used secondary data from the microbiology register in Clinical Microbiology Laboratory and medical record of Sanglah Hospital. This study employed total sampling method to collect samples. There were 52 samples that obtained in this study. Most of them were gram negative bacteria (53.8%). The most common gram negative bacteria found were Pseudomonas sp, with Pseudomonas stutzeri. The most common gram positive bacteria found were Staphylococcus sp, with Staphylococcus hemolitikus. Vancomycin, Linezolid and Tigecyclin have high sensitivity against gram positive bacteria. Carbapenem, aminoglycoside and fourth generation of cephalosporine still had high sensitivity against gram negative bacteria. About 26.9% of bacterias were multidrug resistant organisms (MDRO) and most of them (78.6%) were gram positive. Ceftriaxone as our empirical therapy has low sensitivity (30%) to gram positive bacteria and moderate sensitivity to gram negative bacteria (53.57%). Resistance to cephalosporin might be quite high in this particular clinical setting due to high number of MDRO. It should be taken into account before giving treatment for bacterial meningitis.