Antimicrobial susceptibility of bacteria isolated from cerebrospinal fluids in an Iranian referral pediatric center, 1998-2008.

Antimicrobial susceptibility patterns of bacterial meningitis provide essential information regarding selection of antibiotic therapy for patients with bacterial meningitis. This study presents data on causes of bacterial meningitis and their susceptibility pattern among children at Children's Medical Center (CMC), a referral tertiary care center in Iran. In this comprehensive retrospective study we reviewed microbiology records of all inpatients suspected to bacterial meningitis, during 1998-2008 of period. Of 11269 CSF cultures examined in the study, 329 (2.9%) were positive for bacterial growth. Overall, coagulase negative staphylococci (CONS) were the most frequent group of organism recovered from our CSF cultures (40%), followed by gram negative enteric bacilli (19.7%). Also, high rates of oxacillin and vancomycin resistance were found among staphylococci. In our study more than 80% of gram-negative enteric bacteria were resistant to ampicillin; we also found high rates of cephalosporin resistance among these organisms. Over 55% of S. pneumoniae were resistant to penicillin. Staphylococci species and gram-negative enteric organisms were the most common pathogens isolated from CSF cultures in this study. It seems that nosocomial meningitis is the main cause of bacterial meningitis in CMC Hospital. Our report draws attention to the importance devising a national strategy to control the spread of resistance in Iran.