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

Kamoun, Fatma; Dowlut, Mashuma Bibi; Ameur, S. Ben; Sfaihi, Lamia; Mezghani, S; Chabchoub, I.; Hammami, A.; Aloulou, Hajer; Hachicha, M.

doi:10.3109/15513815.2015.1051252

Cited by 9 publications

(9 citation statements)

References 23 publications

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“…The number of pathogen species described in the included articles varied from 8 to 19. The two main etiologic agents were found to be Group B Streptococcus (GBS) and Escherichia coli in 4 studies [not including ( 9 , 14 , 19 )]. No ANOVA analyses were performed in these articles to determine the exact statistical relationship between these pathogens and outcomes.…”

Section: Resultsmentioning

confidence: 99%

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

et al. 2018

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Background: Neonatal bacterial meningitis is a severe infection with high mortality and morbidity. It is necessary to identify factors associated with a high risk of a poor prognosis so that we can prevent them with more appropriate treatments. This study was performed to summarize the prognostic factors known to predict adverse outcomes in neonatal bacterial meningitis.Methods: The Medline/PubMed, Cochrane Library and Embase databases were searched for studies of prognostic risk factors in neonates with bacterial meningitis. Studies published from the initiation of the database to April 30th, 2017 were included. The quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). The quality of cross-section studies was assessed by the Agency for Healthcare Research and Quality (AHRQ) scale. Each prognostic factor known to cause adverse outcomes is summarized.Results: Sixteen studies were identified, including 7 cohort studies and 9 cross section studies. Seizure and high protein levels in the cerebrospinal fluid (CSF) predict a poor prognosis in this disease. Coma, the need for ventilation support, and leukopenia also had some value for predicting poor prognoses. A bulging anterior fontanelle was valuable for predicting mortality. Low CSF glucose levels, thrombocytopenia, gestational age (GA) < 37 weeks and an altered sensorium were correlated with a poor prognosis. A birth weight < 2500 g, early onset meningitis and positive CSF cultures were correlated with mortality.Conclusions: This study provides a preliminary exploration of prognostic factors in neonatal bacterial meningitis and thereby fills some of the gaps in the study of prognoses in this disease. These prognostic factors can be used to predict and estimate outcomes in neonatal bacterial meningitis. Without a meta-analysis, the reliability of these factors cannot be assured. In addition, these results emphasize that there is an urgent need for a standardized protocol for follow-up and well-designed prognostic studies in neonatal bacterial meningitis.

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Section: Resultsmentioning

confidence: 99%

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

et al. 2018

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“…Five studies of the 72 had a sample size <50 and were included because large studies were not available for those countries: Bosnia and Herzegovina, [ 30 ] Nepal, [ 31 ] Nigeria, [ 32 ] Romania, [ 33 ] and Tunisia. [ 34 ] The methodological quality assessment of each of the included studies is shown in S3 Table . Approximately 90% of these studies were cross-sectional studies (n = 49/72) or surveillance studies (n = 14/72).…”

Section: Resultsmentioning

confidence: 99%

“…[ 83 ] An additional analysis was carried out in our study for data in neonates on the frequency of group B S . agalactiae for all regions and found that the frequency was highest in the European region (but limited to one study only [ 84 ]), and lowest in the Eastern Mediterranean region (based on two studies only [ 34 , 85 ]). It has been estimated that group B S .…”

Section: Resultsmentioning

confidence: 99%

Global etiology of bacterial meningitis: A systematic review and meta-analysis

Oordt-Speets¹,

Bolijn²,

Hoorn³

et al. 2018

PLoS ONE

176

157

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Bacterial meningitis is a global public health concern, with several responsible etiologic agents that vary by age group and geographical area. The aim of this systematic review and meta-analysis was to assess the etiology of bacterial meningitis in different age groups across global regions. PubMed and EMBASE were systematically searched for English language studies on bacterial meningitis, limited to articles published in the last five years. The methodological quality of the studies was assessed using a customized scoring system. Meta-analyses were conducted to determine the frequency (percentages) of seven bacterial types known to cause meningitis: Escherichia coli, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, group B Streptococcus agalactiae, Staphylococcus aureus, and Listeria monocytogenes, with results being stratified by six geographical regions as determined by the World Health Organization, and seven age groups.Of the 3227 studies retrieved, 56 were eligible for the final analysis. In all age groups, S. pneumoniae and N. meningitidis were the predominant pathogens in all regions, accounting for 25.1–41.2% and 9.1–36.2% of bacterial meningitis cases, respectively. S. pneumoniae infection was the most common cause of bacterial meningitis in the ‘all children’ group, ranging from 22.5% (Europe) to 41.1% (Africa), and in all adults ranging from 9.6% (Western Pacific) to 75.2% (Africa). E. coli and S. pneumoniae were the most common pathogens that caused bacterial meningitis in neonates in Africa (17.7% and 20.4%, respectively). N. meningitidis was the most common in children aged ±1–5 years in Europe (47.0%). Due to paucity of data, meta-analyses could not be performed in all age groups for all regions.A clear difference in the weighted frequency of bacterial meningitis cases caused by the different etiological agents was observed between age groups and between geographic regions. These findings may facilitate bacterial meningitis prevention and treatment strategies.

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“…As a result of these findings, together with MRI examination, the patient was diagnosed with GA II complicated purulent meningitis and septicemia. Purulent or bacterial meningitis is characterized by the invasion and growth of bacteria in the CSF, which is more frequent during the neonatal period than at any other period of life [22]. The clinical features of neonatal bacterial meningitis are nonspecific, CSF study through lumbar puncture is the only way to confirm the diagnosis of meningitis and we examined this case.…”

Section: Discussionmentioning

confidence: 99%

A novel electron transfer flavoprotein dehydrogenase (ETFDH) gene mutation identified in a newborn with glutaric acidemia type II: a case report of a Chinese family

Zhu²,

Zhang

et al. 2020

BMC Med Genet

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Background: Glutaric acidemia type II (GA II) or multiple acyl-CoA dehydrogenase deficiency (MADD, OMIM 231680) is an inherited autosomal recessive disease affecting fatty acid, amino acid and choline metabolism, due to mutations in one of three genes namely, electron transfer flavoprotein alpha-subunit, ETFA, electron transfer flavoprotein β-subunit, ETFB and electron transfer flavoprotein dehydrogenase, ETFDH. Currently, few studies have reported genetic profiling of neonatal-onset GA II. This study aimed to identify the genetic mutations in a Chinese family with GA II. Case presentation: We reported a case of GA II with purulent meningitis and septicemia and identified a novel ETFDH gene mutation in a female infant. The patient developed an episode of hypoglycemia and hypotonicity on the postnatal first day. Laboratory investigations revealed elevations of multiple acylcarnitines indicating glutaric acidemia type II in newborn screening analysis. Urinary organic acids were evaluated for the confirmation and revealed a high glutaric acid excretion. Genetic analysis revealed two mutations in the ETFDH gene (c.623_626 del / c. 1399G > C), which were considered to be the etiology for the disease. The novel mutation c.623_626 del was identified in the proband infant and her father, her mother was carriers of the mutation c.1399G > C. Conclusions: A novel variant (c.623_626 del) and a previously reported missense (c.1399G > C) in the ETFDH gene have been identified in the family. The two variants of ETFDH gene identified probably underlie the pathogenesis of Glutaric acidemia type II in this family, and also enlarge ETFDH genotype-phenotype correlations spectrum.

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

Abstract: This study emphasizes the severity of PNM with high rates of mortality and neurological sequelae.

Cited by 9 publications

References 23 publications

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

Global etiology of bacterial meningitis: A systematic review and meta-analysis

A novel electron transfer flavoprotein dehydrogenase (ETFDH) gene mutation identified in a newborn with glutaric acidemia type II: a case report of a Chinese family

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