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Neonatal meningitis
A A Al-Harthi1, K A Dagriri, A A Asindi
1College of Medicine, King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia.
Objective:
To determine the prevalent bacterial agents of neonatal meningitis and their antibiotic susceptibility in a referral intensive care unit in Assir Central Hospital, Saudi Arabia, during the years 1993-1998.
Methods:
Records of newborn infants with positive cerebrospinal fluid culture during the period were retrospectively studied.
Results:
There were 1473 nursery admissions, of which 32 episodes of meningitis occurred amongst 31 neonates. Klebsiella pneumoniae (31%) and Serratia marcescens (21%) were the main pathogens. The incidence of concurrent septicemia among these infants was 58%. Klebsiella pneumoniae appears to dominate in both early and late onset infections. The sex incidence was equal and the mortality rate was 48%.
Conclusion:
The survey identifies Klebsiella pneumoniae and Serratia sp. as the leading bacterial agents of neonatal meningitis in our environment. The relatively high frequency of Serratia infection in the present survey appears unique as this organism is comparatively rare in other reports across the globe. No Group B Streptococcus was isolated, which is in contrast to reports obtained in Europe, America and Australia where it is the predominant organism of neonatal sepsis or meningitis. Antibiogram identified imipenem and cefotaxime as the empirical antibiotics in infants with a clinical diagnosis of neonatal sepsis in our hospital; no more conventional use of ampicillin. In view of the changing bacterial pattern of infant infection with time even in the same environment, a periodic review of this subject is advocated.
Insights
Klebsiella pneumoniae and Serratia marcescens were the primary causes of neonatal meningitis in Saudi Arabia between 1993-1998. This study highlights unique bacterial patterns and guides antibiotic choices for neonatal infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Neonatal meningitis poses a significant threat to infant health.
- Understanding local etiological agents and their antibiotic resistance is crucial for effective treatment.
Purpose of the Study:
- To identify the main bacterial pathogens causing neonatal meningitis.
- To assess the antibiotic susceptibility patterns of these pathogens.
- To inform empirical antibiotic therapy in a Saudi Arabian intensive care unit.
Main Methods:
- Retrospective study of cerebrospinal fluid cultures from neonates.
- Analysis of 32 meningitis episodes from 1473 nursery admissions (1993-1998).
Main Results:
- Klebsiella pneumoniae (31%) and Serratia marcescens (21%) were the predominant pathogens.
- High incidence of concurrent septicemia (58%) observed.
- Mortality rate was 48%.
Conclusions:
- Klebsiella pneumoniae and Serratia sp. are key etiological agents in this region.
- Serratia infection frequency is notably high compared to global reports.
- Imipenem and cefotaxime are recommended empirical antibiotics, replacing ampicillin.