Aeromonas hydrophila meningitis and fulminant sepsis in preterm newborn: A case report and review of literature.

Neonatal meningitis is a lethal infection occurring in the 1st month of life. The risk of developing permanent neurological sequels is high among the neonates who survive. Bacterial pathogens are commonly associated with this condition. Aeromonas is a Gram‑negative bacteria of aquatic habitat. Although isolation of Aeromonas species from neonates with blood stream infection is infrequently reported, neonatal meningitis caused by Aeromonas is exceedingly rare. We present a case of fulminant sepsis and meningitis caused by Aeromonas hydrophila in a preterm newborn male. The bacteria was isolated in culture from blood and cerebrospinal fluid. In spite of targeted antibiotics and supportive therapy, the baby failed to respond and died on the 12th day of life.

Meningitis due to aeromonas hydrophila.

A 3-month-old male child with the history of fever, of not sucking the breast and exhibiting\symptoms of meningitis was brought to the hospital for medical advice and was investigated. Aeromonas hydrophila was isolated thrice from CSF, blood samples as well as the water source.

Bacteraemia in high-risk patients.

In this study, we noticed a high incidence of bacteraemia in high-risk patients especially due to nonfermenter gram negative bacilli (NFGNB) and coagulase negative staphylococci (CoNS). Bacteraemia caused by some rare bacteria such as Moraxella spp., Aeromonas spp., Flavobacterium meningosepticum was also noted during the study. Antibiotic resistance pattern showed that many isolates were Multi Drug Resistant (MDR). This can be attributed to nosocomial-infection, which may occur due to more and more invasive procedures for diagnosis and therapy during long stay of patients in the hospital. Also, the MDR strains and the wide spread oxacillin resistant CoNS (OR-CoNS) and slowly emerging vancomycin resistant CoNS (VR-CoNS) associated with nosocomial infections pose a great threat to the clinicians. We recommend the usage of commonly used antibiotics along with cephalosporins for the patients admitted to these high-risk units, before the antibiotic susceptibility test findings.

Study of coagulase negative staphylococci isolated from blood and CSF cultures.

Coagulase negative Staphylococci (CONS) which were considered as laboratory contaminants and normal flora of skin in man, have emerged as opportunistic pathogens. The infection with CONS has been reported since 1950 with increasing frequency and has been implicated as the causative agents of certain categories of patients viz, neonates with sepsis, cardiac patients with prosthetic valves, immunocompromided patients which include end-renal stage disease, and renal transplantation, burns and cancer patient. These are causing problems to clinicians because of their drug resistance. 180 strains of CONS isolated from blood and CSF during the period of 2 years (Jan 1997-Dec 1998) were studied. Not only they were resistant to Penicillin (P), Ampicillin, (Amp), Oxacillin (Ox), but also developing resistance to Vancomycin (Van) which pose a therapeutic problem. So this study was undertaken and this area needs further exploration.

Drug resistance pattern and phage types of Salmonella typhi isolates in Manipal, South Karnataka.

Out of the 226 strains of S. typhi isolated over a period of three years 57.9% of them were multidrug resistant. 8.8% of the isolates were sensitive to all the drugs tested. A significant decline in hte number of multidrug resistant strains was observed in this region. Majority of the isolates belonged to phage type E (75.7%) and Biotype 1 (93.8%). All strains isolated were sensitive to ciprofloxacin, norfloxacin and ceftriaxone.

Incidence of meningitis in Manipal.

One thousand one hundred and seventy cerebro spinal fluid (CSF) samples from clinically diagnosed meningitis patients were subjected to macroscopic and microscopic examination. CSF samples were also cultured. Five percent CSF samples were positive for bacterial (4.3%) and fungal (0.7%) organisms. Gram positivity was observed in 6.4% samples. The percentage of bacterial isolates was highest in newborn and infants (6.1%) and (4.3%) in patients of 1-12 years age group. Cryptococcus species were isolated from 8 adult patients. Among Gram positive bacterial isolates, coagulase negative Staphylococci was highest (8%), followed by Pneumococci (6%) and B-haemolytic Streptococci (2%). Among Gram negative bacilli, Pseudomonas aeruginosa was predominant (42%) followed by Klebsiella species (20%) though Klebsiella was predominant in newborns and infants.