PS-308 Neonatal Bacterial Meningitis In A Developing Country

Background and aimsNeonatal bacterial meningitis (NBM) is a serious disease with high morbidity and mortality rates.AimsStudy the epidemiological, clinical, bacteriological aspects and the outcome of NBM.MethodsWe report a retrospective analysis of 55 cases of NBM hospitalised in the paediatric depa...

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Bibliographic Details
Published in:Archives of disease in childhood 2014-10, Vol.99 (Suppl 2), p.A222-A222
Main Authors: Kamoun, F, Loukil, S, Sfaihi, L, Ben Ameur, S, Kamoun, TH, Hachicha, M
Format: Article
Language:English
Subjects:
Antibiotics
Attrition (Research Studies)
Bacteria
Blood culture
Body Weight
Cell culture
Cerebrospinal fluid
Diagnosis
E coli
Fever
Infants
Leukocytes (neutrophilic)
Low birth weight
Meningitis
Morbidity
Mortality
Neonates
Neurological complications
Newborn babies
Ofloxacin
Seizures
Sex ratio
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Summary:Background and aimsNeonatal bacterial meningitis (NBM) is a serious disease with high morbidity and mortality rates.AimsStudy the epidemiological, clinical, bacteriological aspects and the outcome of NBM.MethodsWe report a retrospective analysis of 55 cases of NBM hospitalised in the paediatric department between 1990 and 2012. Inclusion criteria were infants less than 29 days of age who were hospitalised for bacterial meningitis diagnosed on either the presence of bacteria in cerebrospinal fluid (CSF) or with more than 30 cells/mm3, predominance of neutrophils, the protein level greater than 1.2 g/l and hypoglycorachia.ResultsThe mean age of diagnosis was 11 days and the sex ratio was 1.75. The patients were premature in 9% and low birth weight in 20% of cases. The main circumstances of discovery were fever (69.1%), refusal to breastfeed (49.1%) and seizures (16.4%). A myelomeninguolcele was present in 6 patients. Blood culture was positive in 34.8% of cases and the CSF culture was positive in 54.4% of cases. The main bacteria isolated was Escherichia coli (7 cases), Streptococcus B (7 cases) and Pseudomonas aeruginosa (5 cases). The cefotaximeampicillingentamicin combination was the most prescribed first-line. Ofloxacin was associated initial antibiotic therapy in 9 cases. The mortality rate was 40% and the sequelae rate in survivors was 27%.ConclusionThis study emphasises the severity of NBM with high rates of mortality and neurological sequelae. An early diagnosis and effective antibiotic therapy is needed to improve the prognosis.
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2014-307384.607