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ORIGINAL ARTICLE
Year : 2013  |  Volume : 3  |  Issue : 3  |  Page : 282-288

Laboratory evaluation of cases of meningitis attending a tertiary care hospital in India: An observational study


1 Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Katihar Medical College and Hospital, West Bengal, India
2 Department of Pathology, College of Medicine and Sagore Dutta Hospital, Katihar Medical College and Hospital, West Bengal, India

Correspondence Address:
Moumita Adhikary
231/1, R.B.C. Road, P.O: Naihati, North 24 Parganas, West Bengal - 743 165
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2231-0738.114861

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Context: Diagnosis of infection involving the central nervous system is of critical importance. Aims, Settings and Design: Objectives were to isolate and identify the organisms causing bacterial meningitis in patients admitted in the intensive care unit of a tertiary care hospital in Bihar, India. To assess the clinical presentation and to further determine the isolates causing meningitis by antigen testing. Materials and Methods: Cerebrospinal fluid (CSF) and blood samples were collected from 83 patients with signs and symptoms of meningitis and were cultured on 5% sheep blood agar, MacConkey's agar and chocolate agar. Smears were made with the centrifuged deposit of CSF and stained by Gram stain, Ziehl Neelsen stain and negative staining. The supernatant was used for latex agglutination test (LAT). Antibiotics susceptibility tests were also performed for all isolates. Statistical Analysis Used: S.S.P.E version 11. Results: Most of the cases of meningitis occurred in winter and spring. Out of 83 cases 38 (45.8%) were found to be cases of bacterial meningitis. The most common presenting feature in both bacterial and aseptic meningitis was fever, followed by altered sensorium. Only 15.7% (13/83) of cases had neck rigidity. The organisms isolated were Escherichia coli 25.6% (10/39), Staphylococcus aureus 15.4% (6/39), Streptococcus pneumonia 10.2% (4/39), Klebsiella species 10.2% (4/39) and Pseudomonas areuginosa 10.2% (4/39). LAT detected bacterial antigens in 16.9% (14/38) cases. The common etiological agent identified was E. coli 10/38 (71.4%) and followed by Streptococcus pneumonia 4/38 (28.6%). Conclusions: To conclude, Gram negative bacilli were found to be more frequently isolated in our series of patients with E. coli being the most common isolate. Established organisms of meningitis such as Haemophilus influenzae and Niesseria meningitidis were not isolated at all, despite all our efforts.


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