Antibiotic resistance in bacterial pathogens causing meningitis in children at Harare Central Hospital, Zimbabwe

Abstract

Objective: To determine the current susceptibility patterns of bacterial pathogens isolated from cases of meningitis in children.

Design: A cross-sectional study of children less than 59 months admitted at a central hospital to determine the susceptibility patterns of bacteria causing meningitis to antibiotics in routine use in Zimbabwe. The disk diffusion and E-testing were done according to Clinical Laboratory Standard Institute (CLSI) methodology determined the Minimum Inhibitory Concentrations (MIC) for penicillin and ceftriaxone.

Setting: Harare Central Paediatric Hospital, a major referral centre in Zimbabwe.

Participants: Children less than 59 months admitted with suspected meningitis whose Cerebrospinal Fluid (CSF) was collected by convenience sampling targeting four types of bacteria namely Neisseria meningitidis, Streptococcus pneumonia, Streptococcus agalactiae and Haemophilus influenzae type.

Results: A total of 15 S. pneumoniae isolates and one H. influenzae isolate were available for antibiotic sensitivity testing. Of these, 13 (86.7%) S. pneumoniae isolates were sensitive to benzyl-penicillin and clindamycin with only 2 (13%) being resistant while all the isolates were sensitive to ceftriaxone and vancomycin. Fourteen (93.3%) were sensitive to chloramphenicol with one isolate (6.6%) resistant. There was total resistance to cotrimoxazole (100%) while 6 (40%) isolates were resistant to tetracycline.

Conclusion: Sensitivity to penicillin was high and the high sensitivity of bacteria to ceftriaxone suggested that it can be recommended for treatment of bacterial meningitis in Zimbabwe. No major changes have taken place in sensitivity of the studied bacterial organisms to the selected antibiotics compared to earlier studies.