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Bacterial meningitis in infants two to six weeks old
Helvetica Paediatrica Acta
|October 1, 1986
Summary
Bacterial meningitis in older neonates (2-6 weeks) presents unique challenges. Early antibiotic selection must cover a broad spectrum of pathogens due to high mortality and neurologic sequelae in this distinct age group.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Bacterial meningitis is a serious infection in neonates.
- Older neonates (2-6 weeks) represent a distinct demographic with potentially different causative agents and outcomes compared to younger infants.
Purpose of the Study:
- To review the experience with bacterial meningitis in older neonates.
- To identify common pathogens, treatment outcomes, and associated neurologic sequelae.
- To inform optimal antibiotic selection for this specific age group.
Main Methods:
- Retrospective review of 17 patients diagnosed with bacterial meningitis.
- Analysis of causative bacteria isolated from cerebrospinal fluid (CSF).
- Evaluation of clinical presentation, treatment, mortality, and neurologic outcomes.
Main Results:
- Common pathogens included pneumococci (29%), E. coli (23%), meningococci (23%), group B streptococci (12%), Enterobacter (6%), and H. influenzae (6%).
- No Listeria monocytogenes infections were observed.
- High mortality rate (30%) and significant neurologic residua (36%) were noted.
- Mean duration of symptoms before admission was 3.1 days.
Conclusions:
- Older neonates with bacterial meningitis exhibit a different spectrum of pathogens than younger infants.
- The high mortality and morbidity underscore the need for prompt and appropriate treatment.
- Empiric antibiotic therapy should encompass the identified spectrum of potential pathogens in this age group.