Objective:
The study aimed to describe the identity and antimicrobial resistance patterns of the
causative agents of bacterial meningitis in children referred to Children’s Medical Center (CMC) Hospital,
Tehran, Iran.
Methods:
This retrospective study was performed at CMC Hospital during a six-year period from 2011 to
2016. The microbiological information of the patients with a diagnosis of bacterial meningitis was collected
and the following data were obtained: patients’ age, sex, hospital ward, the results of CSF and
blood cultures, and antibiotic susceptibility profiles of isolated organisms.
Results:
A total of 118 patients with bacterial meningitis were admitted to CMC hospital. Sixty-two percent
(n=73) of the patients were male. The median age of the patients was ten months (interquartile range
[IQR]: 2 months-2 years) and the majority of them (n=92, 80%) were younger than two years of age. The
highest number of patients (n=47, 40%) were admitted to the surgery department. Streptococcus
epidermidis was the most frequent isolated bacterium (n=27/127, 21%), followed by Klebsiella pneumoniae
(n=20/127, 16%), and Staphylococcus aureus (n=16/127, 12.5%). Blood culture was positive in 28%
(n=33/118) of patients. Ampicillin-sulbactam and imipenem were the most effective antibiotics against
Gram-negative bacteria isolated from CSF cultures. In the case of Gram-positive organisms, ampicillinsulbactam,
vancomycin, and linezolid were the best choices. Imipenem was the most active drug against
Gram-negative blood pathogens. Also, ampicillin and vancomycin had the best effect on Gram-positive
bacteria isolated from blood cultures.
Conclusion:
Results of this study provide valuable information about the antibiotic resistance profiles of
the etiologic agents of childhood meningitis, which can be used for prescription of more effective empirical
therapies.