Clinical Analyzing of Neonatal Purulent Meningitis

Abstract

Objective To study the clinical manifestations, treatment and hospitalized outcomes of neonatal purulent meningitis. Methods This was a prospective observational study with institutional ethics approval of West China Second University Hospital, Sichuan University and written consent from the parents of each participating neonate. From January 2008 to December 2012, a total of 52 neonates with neonatal purulent meningitis in West China Second University Hospital, Sichuan University were recruited. Their clinical manifestations, lab examination results, head image results, and prognoses were analyzed respectively. Results The most frequently signs were low response(61.54%,32/ 52) and fever(57.69%, 30/ 52) , the incidence of nerver system abnormal signs such as abnormal muscle tone(51.92%,27/ 52) , seizure(28.85%,15/ 52) , bulging fontanel(19.23%,10/ 52) and positive meningeal irritation sign(3.85%,2/52) was low among 52 neonates with neonatal purulent meningitis．The positive incidence of the first result of lab test including infection markers in blood and cerebrospinal fluid (CSF) was low also．There had significance difference between blood white blood cell (WBC) and C-reacting protein(CRP) (63.50% vs． 38.46%, P<0.05) , and between WBC and protein amount in CSF (67.31% vs． 38.46%, P<0.01) , respectively．The pathogenic bacteria raised from blood and CSF, Gram-negative(G-) bacteria were more than Gram-positive (G+) , the Escherichia coli took the first place (26.92%, 7/ 26) ; All bacteria were conditional pathogenic bacteria, most of these were multiple resistant bacteria (69.23%, 18/ 26) ．Every patient received at least two antibiotics, the 3rd generation cephalosporin were the most popular(82.69%, 43/ 52) , following meropenem (38.46%,20/ 52) , there were 3 cases used vancomycin and cefepime (4th generation cephalosporin) respectively. Conclusions To discriminate neonatal purulent meningitis early, we need a constant surveillance for neonatal having high risk factors of meningitis and serial CSF examing. Most pathogens were multiple resistant bacteria. It is hard to be cured, and the prognoses are poor. Key words: Meningitis, bacterial; Infant, newborn; Anti-bacterial agents