[Neonatal meningitis: study of 56 cases]

The objective of this study was to know the most common organisms causing neonatal meningitis in a defined region of southern Madrid, the developmental outcome of these babies and the risk factors associated with the prognosis.

This was an observational study of 56 cases of meningitis diagnosed in our Neonatal Service between 1988 and 1994. In order to study the handicaps of these babies, only those who were born before May 1993 were considered so that they had a corrected age of at least 2 years when the neurological evaluations were done.

The most common causative organisms were group B Streptococcus (27%), E. coli (11%) and enteroviruses (9%). In the premature infants the leading organisms were E. coli and Candida albicans. The age at diagnosis was 8 +/- 6 days in the group of preterm infants (p = 0.002). The mortality was associated with the prematurity (risk ratio: 17.8), the isolation of a gram-negative organism in the cerebral fluid (RR: 3.3) and the presence of abnormal findings in cerebral ultrasound studies (RR: 12.7). Sequelae were associated with the presence of abnormal findings in cerebral ultrasound studies (RR: 24.7) or in the neurologic examination (R: 7) and with the presence of previous cerebral lesions (RR: 5.7).

Neonatal ultrasound examination, as well as the gestational age, the causative organisms, the presence of a previous cerebral lesion and the neurological examination, seem to be very important in predicting the prognosis of these babies.