Bacterial and prognostic profile of nosocomial meningitis in newborns

FZ Elhanafi, F. Bennaoui, N. Mahir, NE Slitine, Maoulainine Fmr
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Abstract

Introduction: Nosocomial neonatal meningitis is particularly dreadful because it occurs in patients of immature immunity and a developing brain. It is always a challenge for the clinician due to its clinical polymorphism making the diagnosis often difficult Aim: To study the epidemiological, clinical, bacteriological, therapeutic and evolutionary aspects of neonatal nosocomial bacterial meningitis. Results: Through our series, we reported fourteen cases of nosocomial meningitis, ie 43% of meningitis recorded over the study period. A male predominance was observed in 57.1%. The newborns were preterm in 28% of cases and had low birth weight in 42% of cases. The germ isolated was Klebsiella pneumoniae in 28.4% of cases. The blood culture was positive in 64% of cases. The same germ was isolated in both blood and the cerebrospinal fluid in 42% of cases. The complications found were: ventriculitis (28.5%), triventricular and tetraventricular hydrocephalus (14.2%) and multiple cerebral abscesses (14.2%). The mortality rate recorded in our series was 28.5%. Conclusion: Nosocomial meningitis is a serious or even fatal condition requiring early diagnosis and adequate antimacrobial therapy. Prevention remains the best strategy for the battle against this infection
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新生儿院内脑膜炎的细菌和预后分析
院内新生儿脑膜炎特别可怕,因为它发生在免疫不成熟和大脑发育的患者身上。目的:探讨新生儿院内细菌性脑膜炎的流行病学、临床、细菌学、治疗和进化等方面的特点。结果:通过我们的系列研究,我们报告了14例院内性脑膜炎,即研究期间记录的脑膜炎的43%。男性占57.1%。28%的新生儿早产,42%的新生儿出生体重过低。分离的细菌为肺炎克雷伯菌,占28.4%。64%的病例血培养呈阳性。在42%的病例中,在血液和脑脊液中分离出相同的细菌。并发症包括脑室炎(28.5%)、三室及四室脑积水(14.2%)和多发性脑脓肿(14.2%)。本系列记录的死亡率为28.5%。结论:医院源性脑膜炎是一种严重甚至致命的疾病,需要早期诊断和充分的抗微生物治疗。预防仍然是抗击这种感染的最佳战略
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