Fatores de risco para meningite bacteriana no recém-nascido

Krebs, Vera Lúcia Jornada; Taricco, Luciana Delboni

doi:10.1590/s0004-282x2004000400012

Cited by 14 publications

(14 citation statements)

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“…The clinical systems are frequently inexact and the neurological symptoms are found only when the infection is in advanced stages. Therefore, the awareness of risk factors is critical for both prevention and diagnosis [4].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of newborn bacterial meningitis and sepsis during the pregnancy period for public health care system participants in Salvador, Bahia, Brazil

Silva¹,

Cavalheiro²,

Queirós³

et al. 2007

Braz J Infect Dis

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Bacterial meningitis is still a major public health threat inside developing countries. In Brazil, the Department of Public Health estimates that the prevalence of bacterial meningitis is 22 cases per 100,000 persons. During the neonatal period, the bacterial meningitis develops special characteristics that can result in hearing problems and movement loss due to neurological and psychological damages. This study had the aim to analyze the prevalence of bacterial meningitis and sepsis in newborns during the pregnancy period for those using the public health care system in Salvador-Bahia. One of the goal was to describe the risk factors of bacterial meningitis and sepsis in newborns. A second goal was to identify, based on newborn health records, the difficulties to predict issues with the hearing, neurological and psychological problems. This study has a cross-sectional design. The newborns that were included in this study had bacterial meningitis or sepsis within 0-28 days of life. They were admitted in the maternity wards between June-December 2005 at the newborn intensive unit care. We analyzed 72 reports of newborns and only 11 (17%) were bacterial meningitis or sepsis newborn cases. These cases were associated to high intake of ototoxic drugs that can cause oto and nephrotoxicity, and cause serious sequels on the child development. Nervous system infection is one of the 2 major problems in clinical practice, especially during the first month after birth. During this first month, the nervous system infection develops special characteristics, which are different from regular symptoms and it requires treatment due to the increased risk to develop complications. It is strongly recommended to monitor ototoxic drugs use to prevent effects on the hearing system. Key-Words: Newborn meningitis, sepsis, prevalence, prediction, complications.The neonatal meningitis is an illness characterized as a result of infection and inflammation of the meninges and it typically happens between birth and the first 28 days of life [1].The bacterial infection is more common during the first month after birth compared to other stages of newborns. It has an incidence that varies from 0.22 to 2.66/1,000 newborns in different countries and it tends to be more common in developing countries [2].During the neonatal period, the illness has special characteristics. The etiology, the clinical symptoms and the mortality appear to be different from the observed in older children [3].The mortality varies based on the treatment, with survival rates of 17% to 29% and with complications rate of 15% to 68%. Among the predictive factors for determining the diagnosis of this condition are the premature birth, newborn weight, type of bacteria, predisposition for the microbial germ, the length of the treatment and complications [4].Although there have been medical advances of medicines and preventive medicine, the incidence of newborn bacterial meningitis for the last 30 years has been barely affected. This minor change in the incidence can be linked po...

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Section: Discussionmentioning

confidence: 99%

“…Among the predictive factors for determining the diagnosis of this condition are the premature birth, newborn weight, type of bacteria, predisposition for the microbial germ, the length of the treatment and complications [4].…”

mentioning

confidence: 99%

Prevalence of newborn bacterial meningitis and sepsis during the pregnancy period for public health care system participants in Salvador, Bahia, Brazil

Silva¹,

Cavalheiro²,

Queirós³

et al. 2007

Braz J Infect Dis

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“…Among very low birth weight neonates (<1500 g) the risk is a 10 to 17-fold higher [2][3][4] . In addition to the immaturity of the immunological system, these neonates frequently present risk factors for infection related to maternal diseases or neonatal conditions 1,3,5 . …”

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confidence: 99%

Clinical outcome of neonatal bacterial meningitis according to birth weight

Krebs¹,

Costa²

2007

Arq. Neuro-Psiquiatr.

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-Objective: To describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. Method: Eighty-seven newborns were studied. Thirty-four infants were low birth weight newborn and 53 presented birth weight ≥2500 g. The clinical data were obtained through the analysis of patients' files. Fisher's exact test, the χ 2 and the Mann-Whitney test were applied. Results: Neurological symptoms were more common in infants weighed ≥2500 g (p<0.05). Complications affected half of the cases in both groups. Complications affected half of the cases in both groups, with an overall mortality rate of 11.5%. Conclusion: The rate of complications was high in both groups, regardless of the birth weight. No association was observed between the occurrence of death and birth weight. Infants with positive CSF culture had a poorer prognosis.KEY WORDS: newborn, neonatal meningitis, central nervous system. Evolução clínica da meningite bacteriana neonatal de acordo com o peso de nascimento RESUMO -Objetivo: Descrever a evolução clínica e as complicações da meningite bacteriana de acordo com o peso de nascimento em recém-nascidos admitidos em unidade de terapia intensiva externa durante o período de 11 anos. Método: Foram estudados 87 neonatos, dos quais 34 foram recém-nascidos de baixo peso e 53 apresentaram peso ≥2500 g. Os dados clínicos foram obtidos por análise dos prontuários médicos. Foram realizados teste exato de Fisher, teste do χ 2 e teste de Mann-Whitney. Resultados: Os sintomas neurológi-cos foram mais comuns em neonatos com peso ≥2500 g (p<0,05 ). As complicações ocorreram na metade dos casos em ambos os grupos, com mortalidade global de 11.5%. Conclusão: A freqüência de complicações foi alta em ambos os grupos, independentemente do peso de nascimento. Não houve associação entre óbito e peso de nascimento. Os neonatos com cultura de líquor positiva apresentaram pior prognóstico.PALAVRAS-CHAVE: recém-nascido, meningite neonatal, sistema nervoso central. SP -Brasil. E-mail: verakrebs@uol.com.br Low birth weight newborns present a 3-fold increased risk of acquiring meningitis when compared to those whose birth weight is ≥2500 g 1 . Among very low birth weight neonates (<1500 g) the risk is a 10 to 17-fold higher [2][3][4] . In addition to the immaturity of the immunological system, these neonates frequently present risk factors for infection related to maternal diseases or neonatal conditions 1,3,5 . Dra. Vera Lúcia Jornada Krebs -Rua Iara 123 / 51 -04542-030 São PauloThe objective of this study was to describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. METHODEighty-seven newborns with bacterial meningitis who were admitted to the Neonatal Intensive Care Unit (NICU) of the Instituto da Criança, Hospital das Clínicas, University of São Paulo, from January 1 st , 1994 to December ...

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“…Constatou-se que a prematuridade associada ao baixo peso ao nascer e doenças infecciosas pré-existentes são importantes fatores de risco para o aparecimento de meningite no recém-nascido (KREBS, 2004).…”

Section: Discussionunclassified