Antibiogram profile of septic meningitis among children in Duhok, Iraq

Objectives: To determine the prevalence of bacteria in the cerebrospinal fluid (CSF), and the antibiogram profile in pediatric patients with suspected meningitis. Methods: This descriptive study was conducted between January 2014 and January 2016 in the Hevi Paediatric Teaching Hospital in Duhok, Iraq. The CSF samples were withdrawn from 432 pediatric patients suspected of meningitis. The samples were cultured, and antibiotic sensitivity tests were performed. Results: There were 33 (7.6%) culture positive cases among 432 CSF samples. Among the positives cases, there were 18 culture positive for Streptococcus pneumoniae (S. pneumoniae). There were 4 cases of Viridans streptococci. In addition, there were 2 cases each of Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Non-coagulase staphylococci. There was only one case each of Staphylococcus aureus, Streptococcus pyogenes, Enterococcus species, Haemophilus influenzae, and Pseudomonas aeruginosa (P. aeruginosa). The isolated S. pneumoniae strains showed 47% sensitivity against penicillin, 13% against cefotaxime, but 100% of sensitivity against vancomycin. Isolates of gram-negative bacilli (E. coli, K. pneumoniae, and P. aeruginosa) were 100% sensitive to imipenem and amikacin, but had 0% sensitivity to cefotaxime and vancomycin. All isolates of Staphylococci were sensitive to vancomycin, gentamicin, and clindamycin but were resistant to penicillin and cefotaxime. Conclusion: Streptococcus pneumoniae is currently the leading cause of meningitis among children in Duhok city. The antimicrobial resistance pattern indicates that all isolates of S. pneumoniae were sensitive to vancomycin.