Antibiotic resistance and bacterial spectrum in cerebrospial fluid cultures: Initial insights from Pakistan.

Antimicrobial resistance (AMR) is a rising global health concern, especially in resource-limited countries like Pakistan, where indiscriminate and unregulated use of antibiotics has significantly worsened this problem. The study aimed to analyze the bacterial spectrum and antimicrobial resistance patterns in cerebrospinal fluid (CSF) cultures from patients with suspected bacterial meningitis, providing crucial insights for better infection control and treatment strategies.This retrospective study analyzed 1107CSF cultures were between 2019 and 2024 at the Lady Reading Hospital, MTI, Khyber Pakhtunkhwa, Pakistan, to assess bacterial profiles in patients with suspected bacterial meningitis and investigate the AMR patterns. Among the 106 positive growth cultures, gram-negative bacteria accounted for 84.9 %. Alarmingly, Acinetobacter baumannii was found to be completely resistant to all the nine antibiotics tested, while Salmonella typhi showed resistance to six out of seven tested antibiotics, highlighting their severe multi-drug resistance profile. Moreover, notable resistance was observed in Citrobacter freundii, Enterobacter species, and Staphylococcus aureus. The distribution results indicated that the Klebsiella pneumoniae is more prevalent in males and the 1-13 years age group. These findings highlight the necessity for urgent action on antibiotic stewardship, improved surveillance, and public awareness to mitigate the spread of AMR pathogens, particularly in life-threatening infections such as bacterial meningitis. Strengthening infection control measures and regulating antibiotic usage policies is imperative to curb the growing AMR crisis.