Prevalence, Antibiogram, and Associated Factors of Bacteria Isolated From Presumptive Meningitis Patients at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia

Abstract

Objective: Bacterial meningitis (BM) is a public health threat with considerable mortality and morbidity worldwide; particularly in the meningitis belt of Africa where Ethiopia is located. The study aims to assess the prevalence, antibiogram, and associated factors of bacteria isolated from presumptive meningitis patients at Debre Markos Comprehensive Specialized Hospital (DMCSH), Northwest Ethiopia.Methods: We conducted a cross-sectional study between March 1, 2021, and May 30, 2021. Sociodemographic and clinical data were collected using structured questionnaires. Cerebrospinal fluid (CSF) was collected aseptically, and gram stain, culture, and biochemical tests were performed to identify bacterial isolates. An antimicrobial susceptibility test was conducted using the disc diffusion method on Mueller-Hinton agar (MHA). Data were entered into EpiData version 3.1 (Epidata Association, Denmark) and exported to SPSS version 23 software (IBM Corp., Armonk, NY) for analysis. P values ≤ 0.05 at 95% CI were considered statistically significant.Results: CSF samples from 152 study participants were analyzed and half (50%, 76/152) of them were males. Bacteria were isolated from 17 individuals with an overall prevalence rate of 11.2% (95% CI= 5.9-16.4). The predominant bacterial isolates were Staphylococcus aureus (S. aureus) and Klebsiella pneumonia (K. pneumoniae) each accounting for 29.4% (5/17). About 41% (7/17) of the isolated bacteria were found to be multi-drug resistant (MDR) with the predominance of gram-negative bacteria (6/7). Bacteria prevalence was significantly higher in individuals with stiff neck [adjusted odds ratio (AOR), 95% CI, 47.529 (3.2-10.92), P=0.023] and tonsillectomy [AOR, 95% CI, 137.015 (6.25-12.34), P=0.02]. Conclusion: S. aureus and K. pneumoniae were the leading isolates among presumptive meningitis patients. The alarming presence of a high rate of MDR isolates mandates the need to implement the antibiotic stewardship program in the study setting.