Pattern of cerebrospinal fluid analysis in children above the neonatal age as seen at the University of Port Harcourt Teaching Hospital
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Abstract
Background: Bacterial meningitis is a potent cause of morbidity and mortality in the paediatric age group.The aim of this study was to review the results of analysis the cerebrospinal fluid (CSF) collected from children above the neonatal age who were suspected to be having meningitis and to also determine the susceptibility pattern of these isolates.
Methods: A descriptive retrospective study of results of CSF culture reports taken from paediatric patients aged 1 month to 16 years with clinical suspicion of bacterial meningitis at the University of Port Harcourt Teaching Hospital between January 1, 2009, and December 31, 2014. The CSF samples were subjected to macroscopic examination, white blood cell count, Gram’s stain and culture. Organisms isolated were characterised by standard procedure and antibiotic susceptibility testing was done according to the Clinical Laboratories Standard Institute guidelines. Data were retrieved from laboratory record books and analysed using Microsoft Excel sheet. Results are presented as tables and pie chart.
Results: Five hundred and seventy-four samples were received from children who were above the neonatal age (28 days). Of these, 329 were male (57.3%), 240 were female (41.8%), while in 5 (0.9%) of the samples, the sex was not indicated. Only 10 (1.7%) samples were positive for culture. Of these, Gram-positive cocci were the most common organisms, of which Staphylococcus aureus was the most prevalent, being 7 (70%), followed by Escherichia coli (20%), while the least prevalent organism was β-haemolytic streptococci (10%).
The organisms all exhibited resistance to amoxicillin-clavulanic acid. Ceftazidime exhibited 100% sensitivity against E. coli isolates. Ceftriaxone, cefotaxime and ciprofloxacin exhibited good sensitivity among all the bacteria isolates that were cultured.
Conclusions: There was a low yield of bacteria in CSF culture of paediatric patients at the University of Port Harcourt. The third-generation cephalosporins are still effective in bacterial meningitis in paediatric patients.
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