Comparative Evaluation of Microscopic and Cultural Examination in Bacterial Meningitis Among The Patients Attending Kanti Children Hospital

Abstract

Present study was conducted in Kanti Children’s Hospital, Kathmandu, Nepal among the children suspected of meningitis from June 2006 to September 2006. The main aim of this study was to compare and correlate the microscopic findings of CSF samples with the cultural findings and to find out the incidence of bacterial meningitis among the children visiting Kanti Children’s Hospital. In this study, a total of 431 CSF samples were studied. These samples were subjected for microscopic investigations, biochemical investigation and also cultured on appropriate media. In this study, out of 431 CSF samples, only 21 (4.87%) showed positive culture result.Gram negative isolates were found to be predominant among the study group (52.58%). Highest percentage of the isolates (33.33%) was obtained from the age group of 0-45days (neonates) and 45d-1 year. Among the isolates,Escherichia coli and Staphylococcus aureus were found to be most predominant (28.57% each) followed by Strepto coccus pneumoniae and Haemophilus influenzae type b (9.53% each). Only one (4.76%)Neisseria mening itidiswas isolated during this study. Higher percentage of isolates (85.71%) was obtained from CSF having cell count moret han 100 cells/mm 3 . The association of the cell count with the culture result was found to be statistically significant (P<0.05). Similarly, Gram stain of CSF samples detected more organisms (7.89%) than culture (4.87%). The sensitivity and specificity of the Gram stain was found to be 100% and 96.82% respectively. Highest percentage of isolates was obtained from the CSF with low glucose level (95.23%) and high proteinlevel (95.23%). Antibiotic susceptibility pattern of the isolates showed that most of the isolates were susceptible to Chloramphenicol (85.71%). Ceftraizone was found to be resistant among most of the Gram negative isolates. Key words:Meningitis, CSF (Cerebrospinal fluid), cell count, Gram Stain.