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[Neonatal bacterial meningitis in a tertiary treatment center]
E Ríos-Reátegui1, L Ruiz-González, T Murguía-de-Sierra
1Departamento de Neonatología, Hospital Infantil de México Federico Gómez, México, D.F., México.
Objective:
To determine incidence, etiologic agents and clinical manifestations of bacterial meningitis in patients hospitalized in the newborn ward at the Hospital Infantil de Mexico in Mexico City and establish the incidence of meningitis in newborns admitted with respiratory distress syndrome (RDS) and determine how often blood cultures are negative in bacterial meningitis in this population.
Methods:
Retrospective chart review of patients with bacterial meningitis admitted to our hospital.
Study Period:
January 1990-July 1995.
Results:
There were 959 admissions to the neonatal intensive care unit (NICU). The overall incidence of bacterial meningitis was 32.3/1000 admissions; however, among 170 patients with RDS, [corrected] meningitis was detected in one (5.9/1000 RDS patients). Of the 31 patients with bacterial meningitis, 10 were preterm (PT) and 21 term (T). In the cerebrospinal fluid (CSF) isolates, there was a predominance of gram negative rods (n: 19; 61%). Clinical findings associated to meningitis were non-specific and there were no differences between PT and T infants. From 31 patients, 19 had negative blood cultures at the time of diagnosis (61%). Mortality associated to bacterial meningitis was [corrected] 40% and 23%, for PT and T, respectively (p = NS).
Conclusions:
The incidence of bacterial meningitis in the study population was high. Most isolates in CSF were gram-negative rods. Clinical findings in meningitis were non-specific and there were no differences between PT and T. Most of the patients (61%) had negative blood cultures at the time of diagnosis.
Insights
Bacterial meningitis incidence was high in newborns, with gram-negative rods predominating. Most patients had negative blood cultures, and clinical findings were non-specific.
Area of Science:
- Neonatal infectious diseases
- Pediatric neurology
- Clinical microbiology
Context:
- Bacterial meningitis poses a significant threat to newborns, particularly those with respiratory distress syndrome (RDS).
- Accurate diagnosis and understanding of etiologic agents are crucial for effective treatment and improved outcomes in neonatal meningitis.
- This study examines bacterial meningitis in a Mexican neonatal intensive care unit (NICU) population.
Purpose:
- To determine the incidence, etiologic agents, and clinical manifestations of bacterial meningitis in hospitalized newborns.
- To establish the incidence of meningitis in newborns with RDS.
- To assess the frequency of negative blood cultures in neonatal bacterial meningitis.
Summary:
- The study reviewed 959 neonatal admissions, finding an overall bacterial meningitis incidence of 32.3/1000 admissions.
- Gram-negative rods were the predominant etiologic agents (61%) in cerebrospinal fluid isolates.
- Clinical findings were non-specific, and 61% of patients had negative blood cultures at diagnosis. Mortality rates were 40% for preterm and 23% for term infants.
Impact:
- Highlights the high incidence of bacterial meningitis in this neonatal population.
- Emphasizes the challenge of diagnosing meningitis due to non-specific clinical signs and frequent negative blood cultures.
- Informs clinical practice regarding the management of suspected neonatal bacterial meningitis, particularly concerning diagnostic limitations.