Antibiotic Susceptibility of Gram-Positive Bacteria in Cerebrospinal Fluid
Author Information
Author(s): Wirth Jennifer S., Djukic Marija, Biesner Katrin, Reichard Utz, Nau Roland, Seele Jana
Primary Institution: Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
Hypothesis
Can antibiotic susceptibility testing in cerebrospinal fluid (CSF) provide more accurate results for Gram-positive bacteria compared to standard broth testing?
Conclusion
Some antibiotics are effective in cerebrospinal fluid at lower concentrations than those determined in standard broth, indicating that standard testing may underestimate in situ susceptibility.
Supporting Evidence
- MICs and MBCs were either lower in CSF than in broth or equal in CSF and broth.
- The difference between MICs in CSF and broth was prominent with several antibiotics.
- In no case was the MIC or MBC higher in CSF than in broth.
Takeaway
This study found that some antibiotics work better in the fluid around the brain than in regular lab tests, which means doctors might need to test differently to find the right medicine.
Methodology
Antibiotic susceptibility was tested in cerebrospinal fluid and Mueller–Hinton broth for various Gram-positive bacteria.
Potential Biases
The study used cell-free normal CSF, which may not represent conditions in patients with infections.
Limitations
The study had a low number of bacterial species and strains tested, and results may differ in CSF from patients with meningeal inflammation.
Participant Demographics
Patients with suspected normal pressure hydrocephalus, all with normal CSF leukocyte counts.
Statistical Information
P-Value
p<0.05
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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