Neonatal bacterial meningitis in Turkey: epidemiology, risk factors, and prognosis

Abstract

Introduction: We aimed to determine the incidence, etiology, risk factors and outcome of bacterial meningitis in neonates. Methodology: Neonates who developed bacterial meningitis between 2003 and 2010 in a tertiary hospital in Turkey were included in the study. Patients born in our hospital were defined as Group 1 and patients referred from other centres were defined as Group 2. Patients with evidence of congenital infections or central nervous system malformations were excluded. Demographic features, delivery type, time of onset of meningitis, co-morbidities, clinical features, blood and cerebrospinal fluid (CSF) analysis, cranial sonographic findings, and outcome of patients were recorded. Results: The study comprised 325 meningitis cases identified from 38,023 hospitalised patients in the neonatology unit among 11,8091 live births. Mean gestational age, birth weight, and hospital stay were 36.8±3.7 weeks, 2.480±924 g, and 26±12.4 days, respectively. Almost half (48%) of the patients were diagnosed in the first seven postnatal days and 52% at 8-30 days after birth. CSF culture findings were positive in 59 (18%) patients (28 in Group 1 and 31 in Group 2). Gram-positive bacteria were the responsible agents in 30 (51%) patients, whereas 26 (44%) patients had Gram-negative bacterial meningitis and 3 (5%) had Candida meningitis. Gram-negative bacteria were predominant in Group 1 whereas Gram positive bacteria were predominant in Group 2. Transfontanel ultrasonography revealed pathologic findings in 17.5% of patients. The total mortality rate was 2.5%. Conclusion: This large-scale study provides essential information about the etiology, characteristics, and outcome of neonatal bacterial meningitis in Turkey.

Incidence of meningitis in term neonates with sepsis and antibiotic sensitivity pattern: an observational study

“…In this study, incidence of meningitis is nearly two thirds of neonatal sepsis. Incidence of septicemia and meningitis is more common among Low Birth Weight (LBW) babies (56.25%), which is similar with findings of Hristeva L et al, Altayeb MH et al, Kavuncuoglu et al [20][21][22] Incidence is more common in males with male: female ratio of 3:2. Similar findings were found by Hristeva L et al, Khalessi N et al,.…”

Neonatal purulent meningitis in southern Tunisia: Epidemiology, bacteriology, risk factors and prognosis

“…Late onset meningitis, which typically occurs beyond the 4 th day of life, suggests nosocomial infection or environmental contamination [3]. It is the most common form reported in literature [4,5]. The same trend was noted in our study.…”

“…Gestational age of less than 37 weeks [8,[22][23][24], birth weight below 2500 grams [23], early onset meningitis [4], delay in diagnosis [8] and seizures [7,25] are considered as poor prognosis factors. In our series, an altered state of consciousness was correlated with a higher mortality rate.…”

“…Newborns' brains are highly exposed to neurological complications during the acute phase of purulent meningitis [3,4].…”

Straightforward synthesis of a tetrasaccharide repeating unit corresponding to the O-antigen of Escherichia coli O16

“…The symptoms associated with this disease are unspecific and may ultimately lead to sepsis [2]. The common cause of the neonatal meningitis are bacterial infections in blood, and they start with the bacteria colonizing the gastrointestinal tract [3–4]. Microorganisms associated with neonatal meningitis are Streptococcus, Escherichia coli ( E. coli ) and Listeria monocytogenes [5–6].…”