Bacterial Meningitis Profile in Newborns: Is the Epidemiology Changing?



F. Bennaoui1, 2, *, N. El Idrissi Slitine1, 2, S.B. Cissé1, 2, N. Soraa3, F.M.R Maoulainine2
1 Neonatal Intensive Care Department, Mohammed VI University Hospital and Research, Marrakech, Morocco
2 Team for Childhood, Health and Development, Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco
3 Microbiology` Department, University Hospital Mohamed VI, Marrakech, Morocco

Article Information


Identifiers and Pagination:

Year: 2018
Volume: 10
First Page: 160
Last Page: 165
Publisher Id: TOIDJ-10-160
DOI: 10.2174/1874279301810010160

Article History:

Received Date: 30/6/2018
Revision Received Date: 18/10/2018
Acceptance Date: 19/10/2018
Electronic publication date: 31/10/2018
Collection year: 2018

© 2018 Bennaoui et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Neonatal Intensive Care Department, Mohammed VI University Hospital and Research and Team for Childhood, Health and Development, Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco; E-mail: fatihabennaoui@yahoo.fr


Abstract

Objective:

The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates.

Materials and Methods:

A retrospective study of all cases of meningitis, hospitalized in the neonatal intensive care unit, Mohamed VI University Hospital, from January 2016 to December 2016.

Results:

Twenty of 794 neonates admitted (2.5%) developed meningitis,with a male predominance (12 boys). The mean age of symptom presentation was 5 days. All patients were symptomatic. The most common clinical features were: fever, respiratory distress and seizure. Microbiological analysis of cerebrospinal fluid was positive in 14 cases and resulted in the isolation of several unusual species such as, Streptococcus pneumoniae (4 cases), Coagulase-negative Staphylococci (3 cases), Enterococci (2 cases), Acinetobacter baumannii (2 cases) and one case each of Escherichia coli , Neisseria meningitidis and Klebsiella pneumonia. Interestingly, the two A. baumannii cases were nosocomially-acquired, while the origins of the other infections were community-acquired. Gram-positive bacteria were more frequently responsible (9/14, 64%). All cases were treated with a combination of third-generation cephalosporins-aminoglycosides, 1 case as treated by by adding ciprofloxacin and 3 cases were treated by adding glycopeptide antibiotics to the clinical therapeutic regimes. We reported 3 cases complicated with hydrocephalus. The mortality rate was 25%.

Conclusion:

Bacterial meningitis is a medical emergency, and immediate diagnostic steps must be taken to establish the specific cause so that appropriate antimicrobial therapy can be initiated. Even with optimal therapy, morbidity and mortality may occur. Neurologic sequelae are common among survivors.

Keywords: Antibiotics, Bacterial meningitis, Cerebrospinal fluid, Lumbar puncture, Neonatal, Nosocomial.