Meningite bacteriana neonatal agentes etiológicos em 109 casos durante período de dez anos

Abstract

The etiology of purulent meningitis was investigated in 109 newborn infants admitted in a neonatal intensive care unit throughout a ten year period. Bacterial pathogens were isolated from the CSF in 57 (52.2%) neonates. There was a predominance of Gram-negative bacilli isolated in 38 (34.9%) neonates. Gram-positive cocci were isolated from CSF in only 12 (11.0%) neonates. Microorganisms associated with nosocomial septicemia and meningitis in neonates--Klebsiella sp, Salmonella sp. Enterobacter sp, Pseudomonas sp, Flavobacterium meningosepticum and Serratia marcescens--were responsible for presumptive etiology in 38 (49.3%) among 77 patients with positive cultures in "closed sites". They were isolated from 22 (57.0%) neonates with prior hospitalization but only from 12 (34.3%) neonates coming directly from their households (chi 2 = 4.08; p < 0.05). The mortality rate was significantly higher in patients with positive CSF cultures (47.4%) in comparison to patients with negative cultures (18.4%) (X2 = 5.01; p < 0.05). It is possible to conclude that Gram-negative bacilli, many of them of hospital origin, are the major pathogens in this study. An improvement on neonatal health care and a scrupulous control of neonatal nosocomial infections are recommended.

Fatores de risco para meningite bacteriana no recém-nascido

“…Além disso, os procedimentos invasivos, freqüentemente necessários para a sobrevida dos recém-nascidos pré-termo e de baixo peso, expõem os mesmos à colonização e infecção por patógenos que podem causar sepse e meningite. Entre os microorganismos isolados nas culturas dos neonatos de nossa casuística observamos a presença de bactérias sugestivas de contaminação hospitalar, como Pseudomonas aeruginosa, Klebsiella pneumoniae, Flavobacterium indologenes 12 Acinetobacter baumanii, Alcalygenes xilosoxidans e Staphylococcus epidermidis 16,17 .…”

Incidência de meningite em pacientes de 0 - 12 anos no Instituto de Medicina Tropical de Manaus

“…Não foram encontradas grandes divergências entre a prática médica avaliada no Instituto de Medicina Tropical de Manaus e o que rege a literatura [3][4][5][6][7][8][9][10][11][12] , consolidando-se dessa forma a observação de que, apesar de nossa região apresentar características tropicais, com o clima muito quente e úmido, não houve interferência em relação a uma maior manifestação da doença. Observamos ainda que as condições sócio-econômicas peculiares desta região, também não alteraram significativamente a prevalência da doença.…”

Involvement of human and canine MRP1 and MRP4 in benzylpenicillin transport

“…Because of their wide spectrum and broad therapeutic index, they are among the most commonly prescribed antibiotics in treating bacterial infections, including those of the CNS[20, 21]. That includes neonatal purulent meningitis, which has a high mortality rate and causes neurological sequelae and lifelong impairment[22, 23]. Although uncommon, beta-lactam antibiotic toxicity is severe and antibiotic resistance also often develops[24, 25].…”