Epidemiological Characteristics and Drug Resistance Analysis of Cerebrospinal Fluid Microbial Infections in Wenzhou Area

Abstract

Objective

Central nervous system infections (CNSI) are serious diseases that endanger human health. Identifying pathogens and their susceptibility to antibiotics, and promptly using antibiotics under this guidance is essential for treatment. The purpose of this study is to investigate the pathogen characteristics of CNSI patients, which can help clinicians choose appropriate empiric antibiotic .

Methods

We retrospectively collected data on CNSI patients with cerebrospinal fluid (CSF) culture positive from 2012 to 2020, including demographic characteristics, laboratory data, pathogenic bacteria, and antimicrobial susceptibility test results.

Results

A total of 166 patients with 168 isolates out of 8188 patients were available for data analysis. Among the isolates, Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 59.5%, 36.3%, and 4.2%, respectively. Among newborns, children under 12, and patients over 12, the most isolated strains were Streptococcus agalactiae (24/46, 52.2%), Streptococcus pneumoniae (21/68, 30.9%) and Staphylococcus epidermidis (10/54, 18.5%), respectively. Streptococcus agalactiae is more sensitive to linezolid and vancomycin. Streptococcus pneumoniae is more sensitive to vancomycin. Staphylococcus epidermidis is more sensitive to clindamycin and rifampicin. The sugar content in the CSF of Gram-negative bacteria of children ≤12 years old was significantly lower than that of Gram-positive bacteria (P<0.05).

Conclusion

We comprehensively studied the etiological characteristics and antimicrobial resistance patterns of positive cerebrospinal fluid cultures in Wenzhou City, Zhejiang Province from 2012 to 2020, which can provide valuable strategies for preventing pathogens and improving evidence-based treatment.

Keywords:

• cerebrospinal fluid
• bacterial culture
• drug resistance
• epidemiological characteristics

Acknowledgments

The results published here are completely based on the data detected by the Microbiology Laboratory of the Clinical Laboratory Center. We thank them for their contributions.

Abbreviations

CNSI, central nervous system infections; CSF, cerebrospinal fluid; MBT, MALDI BioTyper^®; MIC, the minimum inhibitory concentration; CLSI, Clinical and Laboratory Standards Institute; GBS, Group B streptococcus/Streptococcus agalactiae; IAP, intrapartum antibiotic prophylaxis; EOD, early-onset disease.

Data Sharing Statement

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

The study was approved by the Ethical Committee of the Second Affiliated Hospital of Wenzhou Medical University (Approval No: 2021-K-11-01). Written informed consent of patients under 18 years old was obtained from the parents or legal guardians, and this study was conducted in accordance with the Declaration of Helsinki.

Author Contributions

All authors are aware and agree to the content of the paper and to their being listed as an author on the manuscript. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.

Disclosure

Neither this paper nor any similar paper has been or will be submitted to or published in any other scientific journal. There is no conflict of interest or competing financial interests for all authors.