Antibiotic Susceptibility Pattern of E. coli Isolates from Cases of Pediatric Meningitis

Abstract Background: Bacterial meningitis (BM) is a dangerous illness with a high death rate. Among the children, Escherichia coli ( E. coli ) is the leading cause of BM. Objectives: This study aims to investigate the antibiotic resistance of E. coli isolated from BM samples in Babylon. Materials and Methods: The current study collected 200 CSF samples from patients suspected of meningitis at hospitals in Babylon from November 2023 to April 2024. All samples underwent chemical and agricultural tests to confirm the presence of the infection. Using Vitek 2 for a confirmed diagnosis, the disk diffusion method was employed to test the sensitivity of the isolates to antibiotics, and positive samples were tested for resistance genes using polymerase chain reaction (PCR). Results: E. coli was found in 4% of CSF samples, and with low glucose levels of less than 40 mg/dL, the white blood cell count is greater than 100 cells/mm 3 , and the protein level is more than 60 mg/dL. The positive isolated samples were tested for their sensitivity to antibiotics, revealing 75% resistance to amoxicillin-clavulanic acid, 62.5% resistance to ciprofloxacin, gentamicin, and cefotaxime, 50% resistance to erythromycin, ceftazidime, and ceftriaxone, 87.5% sensitivity to imipenem, meropenem, and amikacin, 75% sensitivity to aztreonam, and 62.5% sensitivity to levofloxacin and tobramycin. PCR analysis for resistance genes indicated 87.5% fim H, 62.5% bla CTX-M, and 100% neu C. Conclusions: The study found several antibiotic susceptibility patterns in E. coli isolates. The reason for this resistance may be attributed to the presence of the neu C, fim H, and CTX-M genes. This output provides treatment options for E. coli in the cerebrospinal fluid.