Mycoplasma meningitis in infants with spina bifida

Infants with myelomeningocele are liable to develop bacterial colonisation of the lesion which, in the case of Gram-negative bacteria, often progresses to meningitis because of the infants' immature immune status. The time and origin of the bacterial colonisation usually are uncertain. This study reports seven cases of meningitis caused by Mycoplasma hominis, an organism not previously reported to cause meningitis. The commensal status of Mycoplasma hominis in the vagina of many women, and its isolation from the mother of one patient in this group, suggests that the infant acquired the organism in the birth canal and that infection developed over a period of days. Routine cultures from the sac or wound did not show the presence of organisms until after the child had developed signs and symptoms of meningitis. Commensal organisms from the vagina may lie dormant for several days within the closed myelomeningocele and their more virulent strains may then produce meningitis. It is suggested that neonatal meningitis may be caused by organisms acquired during birth, as well as by those to which the infant is exposed later.