Bacterial profile and resistance trends of pathogens implicated in bacterial meningitis: A four years retrospective study

Background: Study aims to determine the bacterial profile associated with bacterial meningitis, their antimicrobial resistance pattern providing antimicrobial stewardship guidance and improving the efficacy of empirical treatment. Methods: Four years case-series retrospective study (December 2019- December 2023), of positive CSF cultures in 432 patients of various age groups and departments in Ain Shams University Hospital Cairo Egypt were analyzed. Results: predominance of gram-negative bacteria constituting 79.1%, while 19.6% were attributed to gram-positive in bacterial meningitis. Notably, Klebsiella pneumoniae had the highest prevalence at 34%, followed by Acinetobacter spp. at 19.6%. Whereas, Streptococcus pneumoniae exhibited a lower prevalence of 1.8%. The age group >16-50 years demonstrated the highest prevalence at 26.6%, followed by infants aged 2 months to <1 year, with a prevalence of 23.3%. Antimicrobial resistance was predominantly against Ceftriaxone 89%, and Ampicillin 87.9%. Conversely, pathogens exhibited greater sensitivity to Tobramycin (46.2%) and Gentamicin (43.1%) than other antimicrobials. Multidrug resistance was identified in 53.5% of gram-negative bacteria. These results highlight gram-negative bacteria role in meningitis. Conclusion: This study revealed significant changes in meningitis bacterial profiles, highlighting the importance of reinforcing antimicrobial stewardship efforts to effectively combat the evolving landscape of bacterial meningitis.