Prevalence of Bacterial isoLates from Cerebrospinal Fluid, their Antimicrobial Susceptibility Pattern and Associated Risk factors with Special Emphasis on Streptococcus Pneomoniae Among Pediatrics suspected meningitis patients at Tikur Anbessa and Yekatit 12 Specialized Hospitals, Addis Ababa, Ethiopia
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Date
2014-05
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Addis Ababa University
Abstract
Background: Bacterial meningitis remains a major cause of mortality and morbidity in
neonatology and pediatrics patients in many countries of the world including Ethiopia.
Information on prevalence of bacterial meningitis, susceptibility of the causative microorganism
to rationalize treatment and associated risk factors is scare among pediatrics groups.
Objective: To isolate bacteria’s from CSF specimen, determine antimicrobial susceptibility
pattern and to assess associated risk factors with special emphasis on Streptococcus pneumoniae
among pediatrics suspected meningitis patients attending pediatrics clinic at Tikur Anbessa and
Yekatit 12 specialized hospitals, Addis Ababa, Ethiopia.
Methodology: A hospital based cross sectional study was conducted at Tikur Anbessa and
Yekatit 12 specialized hospitals, from September, 2013 to January, 2014. A consecutive
sampling technique was used. Three hundred eighty five pediatrics patients attending the hospital
at pediatrics ward that were gave CSF samples for diagnostic purpose were enrolled in the study.
Samples were taken from them and analyzed according to standard microbiological (culture)
procedures, antimicrobial susceptibility pattern were determined using disc diffusion technique
and serological (BinaxNOW streptococcus pneumoniae antigen test) procedure was also done.
Datas were double entered with EPI INFO version 3.5.3 and analyzed using SPSS version 21
software. Binary logistic regression was used to identify the association between variables.
Sensitivity, specificity, PPV and NPV were used to see the performance of the ICT.
Result: Bacterial pathogens were isolated from 17 patients showing an isolation rate of
4.4%.Among these, 58.8% and 41.2% were gram negative and gram positive organisms
respectively. The most commonly isolated bacteria were S.pneumoniae (35.3%), followed by
Neisseria meningitidis (11.8%). Among all risk factors assessed, none of them were statistically
significant with suspected meningitis cases (p>0.05). The antimicrobial sensitivity remained high
for third generation cephalosporins for most of the isolates. The ICT increased the detection of
pneumococcus over culture.
Conclusion The prevalence of bacterial isolates in this study was 4.4%. Antigen detection
(BinaxNOW S.pneumoniae test in our study) is a better adjuvant to culture. Frequency of single
as well as multiple drug resistance was very high among the bacterial isolates. Area specific
periodic evaluation of antimicrobial susceptibility test will be important
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Yekatit 12 Specialized Hospitals