# The Agents Isolated from Cerebrospinal Fluid and Antibiotic Susceptibility of Adult Patients in a Training and Research Hospital

## Authors

- Sümeyye Akyuz ([ORCID](https://orcid.org/0000-0003-1999-7827)) — Department of Medical Microbiology, Erzincan Binali Yıldırım University, Erzincan, Turkey
- Hasan Yasar ([ORCID](https://orcid.org/0000-0001-8601-1277)) — Department of Neurology, Erzincan Binali Yıldırım University, Erzincan, Turkey

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 9, Issue 1 (2023), pages 24–29
- **Article type:** Original Article
- **Published online:** 2023-03-09
- **DOI:** [10.5455/umj.20221215051347](https://doi.org/10.5455/umj.20221215051347)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=103771
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/103771.pdf

## Abstract

Introduction: This study aims to investigate the antibiotic resistance of the agents isolated from cerebrospinal fluid (CSF) samples of adult patients in our hospital for five years to contribute to surveillance data. Materials and Methods: 121 CSF samples were included in the study between January 2015 and January 2020. Identification of isolates and determination of antibiotic susceptibility profile was performed according to EUCAST criteria with VITEK 2 (bioMérieux, France) automated system. Results: Microorganisms (n=39) were isolated in 37 (30.6%) 121 cerebrospinal fluid cultures. The most frequently isolated agent is coagulase-negative staphylococci (CNS) by 30.8%. It is followed by Micrococcus spp (%15.4), Streptococcus pneumoniae (%10.3), Klebsiella pneumoniae (%10.3), Acinetobacter baumanii (%10.3), S. aureus (%5.1) and Corynebacterium spp (%5.1). 29 (74.4%) of the agents were isolated from hospitalized patients and 10 (25.6%) outpatients. Oxacillin resistance was found at 83.3% in CNS, and penicillin resistance was found at 25% in Streptococcus pneumoniae. Antibiotics to which K. pneumoniae and A.baumannii isolates are most sensitive are tigecycline and amikacin, respectively. Conclusion: Different regions and patient populations might cause differences in isolated agents and antimicrobial susceptibility. Retrospective analysis of regional data will assist the clinician in treating patients diagnosed with meningitis, where empirical and agent-oriented therapy is vital.

## Keywords

Cerebrospinal fluid; antibiotic resistance; bacterial meningitis

## How to cite

Akyuz S, Yasar H. The Agents Isolated from Cerebrospinal Fluid and Antibiotic Susceptibility of Adult Patients in a Training and Research Hospital. Ulutas Med J. 2023;9(1):24-29. doi:10.5455/umj.20221215051347

## References

1. Willke Topçu A, Söyletir G, Doğanay M. Enfeksiyon hastalıkları ve mikrobiyolojisi sistemlere göre enfeksiyonlar 3, Baskı, İstanbul: Nobet Tıp Kitabevleri. 2008
2. Mengistu A, Gaeseb J, Uaaka G, Ndjavera C, Kambyambya K, Indongo L, et al. Antimicrobial sensitivity patterns of cerebrospinal fluid (csf) isolates in namibia: Implications for empirical antibiotic treatment of meningitis, Journal of pharmaceutical policy and practice. 2013; 6(1):1-10 https://doi.org/10.1186/2052-3211-6-4
3. Yanik K, Yilmaz H, Karadağ A, Ercan Ü, Günaydin M. Nozokomiyal ve toplumsal kökenli menenjit şüpheli hastaların beyin omurilik sıvısı’ndan İzole edilen mikroorganizmalar ve antibiyotik duyarlılıkları, International Journal of Basic and Clinical Medicine. 2014; 2(3):131-37
4. Duman Y, Yakupoğulları Y, Tekerekoğlu MS, Güçlüer N, Otlu B. Bir üniversite hastanesi laboratuvarında beyin omurilik sıvısı’nda izole edilen mikroorganizmaların üç yıllık geriye dönük analizi, Dicle Tıp Derg. 2012; 39(1):70-4
5. Pehlİvanoğlu F, Yaşar KK, Şengöz G. Beyin omurilik sivisindan izole edilen mikroorganizmalar ve antibiyotik duyarliliklari, Ankem Derg. 2011; 25(1):1-5
6. Cusack T, Ashley E, Ling C, Rattanavong S, Roberts T, Turner P, et al. Impact of clsi and eucast breakpoint discrepancies on reporting of antimicrobial susceptibility and amr surveillance, Clinical Microbiology and Infection. 2019; 25(7):910-11 https://doi.org/10.1016/j.cmi.2019.03.007
7. Mcgill F, Heyderman RS, Panagiotou S, Tunkel AR, Solomon T. Acute bacterial meningitis in adults, The Lancet. 2016; 388(10063):3036-47 https://doi.org/10.1016/s0140-6736(16)30654-7
8. Couffin S, Lobo D, Cook F, Jost P, Bitot V, Birnbaum R, et al. Coagulase-negative staphylococci are associated to the mild inflammatory pattern of healthcare-associated meningitis: A retrospective study, European Journal of Clinical Microbiology & Infectious Diseases. 2018; 37(4):755-63 https://doi.org/10.1007/s10096-017-3171-9
9. Mashaly GE-S, El-Mahdy RH. Vancomycin heteroresistance in coagulase negative staphylococcus blood stream infections from patients of intensive care units in mansoura university hospitals, egypt, Annals of clinical microbiology and antimicrobials. 2017; 16(1):1-5 https://doi.org/10.1186/s12941-017-0238-5
10. Altuntas F, Yildiz O, Eser B, Gündogan K, Sumerkan B, Çetin M. Catheter-related bacteremia due to kocuria rosea in a patient undergoing peripheral blood stem cell transplantation, BMC infectious diseases. 2004; 4(1):1-3 https://doi.org/10.1186/1471-2334-4-62
11. Ku Y-H, Chuang Y-C, Chen C-C, Lee M-F, Yang Y-C, Tang H-J, et al. Klebsiella pneumoniae isolates from meningitis: Epidemiology, virulence and antibiotic resistance, Scientific reports. 2017; 7(1):1-10 29 77 Cerebrospinal Fluid and Antibiotic Susceptibility Sümeyye Akyüz & Hasan Yaşar https://doi.org/10.1038/s41598-017-06878-6
12. Kurtaran B, Kuşçu F, Ulu A, İnal A, Kömür S, Kibar F, et al. The causes of postoperative meningitis: The comparison of gram-negative and gram-positive pathogens, Turkish neurosurgery. 2018; 28(4) https://doi.org/10.5137/1019-5149.jtn.20575-17.1
13. Uzun Ö, Ünal S, editors.BookGüncel bilgiler ışığında infeksiyon hastalıkları i. Place: Bilimsel Tıp Kitabevi, 2002. pages
14. Çikman A, Parlak M, Gültepe B, Güdücüoğlu H, Berktaş M. Hastane kökenlİ acinetobacter baumannii izolatlarında duyarlılığın e-test yöntemİyle araştirilmasi, ANKEM Derg. 2011; 25(2):79-83
15. Oordt-Speets AM, Bolijn R, Van Hoorn RC, Bhavsar A, Kyaw MH. Global etiology of bacterial meningitis: A systematic review and meta-analysis, PloS one. 2018; 13(6): e0198772 https://doi.org/10.1371/journal.pone.0198772
16. Erdem H, Kilic S, Coskun O, Ersoy Y, Cagatay A, Onguru P, et al. Community-acquired acute bacterial meningitis in the elderly in turkey, Clinical microbiology and infection. 2010; 16(8):1223-29. https://doi.org/10.1111/j.1469-0691.2009.03039.x
17. Dewé TC, D’aeth JC, Croucher NJ. Genomic epidemiology of penicillin-non-susceptible streptococcus pneumoniae, Microbial genomics. 2019;5(10): e000305 https://doi.org/10.1099/mgen.0.000305