Prevalence of Resistant Streptococcus Pneumoniae Causing Meningitis in a Tertiary Care Hospital in Saudi Arabia

Acute bacterial meningitis is associated with high rates of morbidity and mortality. Streptococcus pneumoniae is a major cause in adults and children. Choice of empirical antibiotics must be made in consideration of the global increase of resistant strains to penicillin and third-generation cephalosporins. In order to determine the most common pathogens responsible for bacterial meningitis in King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia, we did a retrospective review of all positive cerebrospinal fluid (CSF) cultures submitted from 1/2006 to 8/2016 for all ages. We identified all causative organisms, and determined the susceptibility pattern of S. pneumoniae and gathered clinical outcome data. The microbiology lab have received a total of 7958 CSF cultures, with 456 (6%) being positive for bacteria or fungi. The most common isolated organisms were the group of coagulase negative Staphylococci. S. pneumoniae was isolated from 15 samples from 13 different patients. Out of the 13 isolates, three showed resistance to penicillin or ceftriaxone (23%). This suggests that drug resistant S. pneumoniae causing meningitis is not uncommon in our hospital. The addition of empirical vancomycin to third-generation cephalosporins to treat community-acquired meningitis might be necessary especially in high risk cases.