348. Streptococcus agalactiae, Streptococcus pneumoniae, Neisseria meningitidis, and Enterobacateriaceae as Leading Causes of Bacterial Meningitis in Infants Younger than 3 Months Old in a Mexican Hospital: 6 Years of Active Surveillance

Abstract

BackgroundIn Mexico, several publications have mentioned that Enterobacteriaceae are the main causes of bacterial meningitis (BM) in young infants (<3 months), with S. agalactiae (GBS) and other bacteriae present in a much lesser extent; however, these studies have been performed mostly at Mexico City, and little is known on the northwest Mexico/US Border, particularly at Tijuana, Mexico (the highest transited frontier in the planet).MethodsSince January 1, 2012 until December 31, 2017 (6 years) we underwent active/prospective surveillance to identify all causes of non-nosocomial–acquired BM in infants <3 months old at the Tijuana General Hospital, Mexico. Bacterial identification was performed either by cultures or PCR, pneumococcal serotyping by the Quellung Reaction (Statens Serum Institute®) or PCR, and meningococcal serogrouping using the Pastorex-Agglutination Meningitis kit (Alere, Ltd.®)., Demographic, clinical, laboratorial, and microbiological data were saved, and statistical analysis was merely descriptive.ResultsIn 6 years, 20 BM cases (3.33 per year) were identified, among which 16 (80%) were newborns <1 month old. GBS was the leading cause (7 = 35%), followed by S. pneumoniae (4 = 20%, serotypes 19A, 33C, 18B, and 12), N. meningitidis (3 = 15%, serogroups C, Y, and B), Enterobacteriaceae (3 = 15%, E. coli, E. clocae, P. mirabilis), N. gonorrheae (2 = 10%) and L. monocytogenes (1 = 5%), see Figure 1. Overall lethality was of five (25%). Highest mortality was found in newborns <7 days old (66.6%), and BM caused by Enterobacteriaceae (66.6%). Among survivors, seven (35%) developed sequelae 3 months following discharge.ConclusionEtiology of BM in young infants in Tijuana differs from Mexico City, with GBS, S. pneumoniae, N. meningitidis as leading causes, along with Enterobacteriaceae. BM in young infants is associated with high mortality and morbidity, especially in newborns and those caused by Enterobacteriaceae. Preventive measures, such as mother screening for GBS carriage/penicillin prophylaxis, as well as early vaccination vs. S. pneumoniae and N. meningitidis should be considered based on further results obtained from this active surveillance in the future. Disclosures All authors: No reported disclosures.