Culture Positivity of Cerebrospinal Fluid by Automated Blood Culture System in Neonates: A Cross-sectional Study from Loni, Maharashtra, India

Introduction: Bacterial meningitis especially in neonates remains a major cause of mortality and long term health sequelae. There is a need for periodic review, since pathogens responsible for the meningitis vary with time and geography.

Aim: To find the culture positivity of Cerebrospinal Fluid (CSF) specimens before and after installation of automated blood culture and identification system in suspected neonatal meningitis cases.

Materials and Methods: The present descriptive cross-sectional study was carried out during July 2020 to December 2020, for six months duration in Department of Microbiology, Rural medical college, (Pravara Institute of Medical Sciences-Deemed University), Loni, Maharashtra, India. All CSF specimens from neonates <28 days received in Department of Microbiology were included in the study. All CSF specimens collected in BacT/Alert bottle were incubated and further subjected to identification by Vitek 2 system. All CSF specimen smears, received were subjected to Gram staining and Ziehl Neelsen Staining. Descriptive statistics was used for result analysis.

Results: A total of 265 CSF specimens were received during the study period. Males (59%) outnumbered females (41%) in the present study. Bacterial growth by automated blood culture system (BacT/Alert 3D) was detected in 85 CSF specimen giving the culture positivity as 32.08%. The most common bacterial isolate was found to be Staphylococcus haemolyticus followed by Enterococcus species and Acinetobacter species. Also, an attempt was made to compare culture positivity results with results by conventional culture method before installation of automation which showed heightened results for culture positivity and diversity of clinical isolates.

Conclusion: Bacterial neonatal meningitis is a common entity and aetiological diagnosis is crucial in every healthcare setting. The present study describes the various aetiological agents isolated by automated blood culture system in neonatal CSF specimens. Retrospective comparison with conventional culture has shown promising results for automated system. Early isolation and definitive identification with drug sensitivity, has got massive impact in management of neonate, further in timely progression of child’s developmental milestones.