Bacteriological Profile and Antimicrobial Susceptibility Patterns in Acute Bacterial Meningitis Among Children

Objective: To determine the etiological profile and antibiotic sensitivity patterns of bacterial pathogens isolated from cerebrospinal fluid (CSF) in pediatric patients with suspected meningitis at a tertiary care center.Methodology: This descriptive cross-sectional study was conducted at Punjab Rangers Teaching Hospital, Lahore, from November 2024 to July 2025. Standard microbiological procedures were followed in the processing of CSF samples taken from hospitalised individuals. Pathogens were initially identified by colony morphology, Gram staining and biochemical tests. Gram-negative organisms were identified by using API 10S. The standard Kirby-Bauer disc diffusion technique was used for antimicrobial susceptibility testing and was interpreted according to the latest CLSI guidelines. The minimum inhibitory concentrations (MICs) of vancomycin and penicillin were ascertained using the E-test technique. Results: Out of 354 suspected cases, 77 (21.8%) were confirmed cases of meningitis. Streptococcal speciespredominatedamongGram-positiveorganisms,whilelactose-fermentingbacteria,includingE. coli, dominated among Gram-negative isolates. Gram-positive bacteria exhibited high sensitivity to vancomycin and linezolid. Lactose fermenters showed poor sensitivity to beta-lactams, extended-generation cephalosporins, and quinolones. Most non-lactose fermenters were sensitive to colistin. Conclusion: Gram-positive and Gram-negative bacteria were highly prevalent in CSF samples from patients with bacterial meningitis, with many showing low susceptibility to multiple antibiotics. These findings highlight the need for accurate diagnosis and antibiotic selection guided by local resistance patterns to support antimicrobial stewardship and infection control.