Antimicrobial Susceptibility Patterns of Bacterial Isolates from Pediatric Cases of Acute Bacterial Meningitis: A 5-year Retrospective Study from a Tertiary Care Hospital in North India

vaccines has led to a significant reduction in the incidence of the disease.However, in India and other developing countries, these pathogens continue to be major contributors to acute bacterial meningitis (ABM). 5,6icrobiological profiling through cerebrospinal fluid (CSF) analysis, culture, and advanced molecular techniques remains the cornerstone for definitive diagnosis and guiding targeted antimicrobial therapy.Understanding regional trends in causative IntroductIonAcute bacterial meningitis (ABM) remains a leading cause of childhood morbidity and mortality in children globally, with the greatest impact seen in low-and middle-income nations.It is characterized by inflammation of the meninges resulting from bacterial invasion of the central nervous system (CNS), which can progress rapidly and lead to neurological complications or death if not promptly diagnosed and treated. 1 In pediatric populations, especially in neonates and young children, the clinical presentation may be nonspecific, complicating early diagnosis and management. 2 The causes of bacterial meningitis in children differ depending on factors such as age, geographic location, vaccination coverage, and health care accessibility.In infants under 2 months of age, the most frequent causative agents are groups B and D streptococci, Gram-negative enteric bacilli, and Listeria monocytogenes.In contrast, children between 2 months and 12 years are most commonly affected by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae type b. 3 Before the introduction of vaccination, meningitis caused by S. pneumoniae and H. influenzae was widespread. 4 In developed nations, the introduction of pneumococcal conjugate and H. influenzae type