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PS-308 Neonatal Bacterial Meningitis In A Developing Country
  1. F Kamoun,
  2. S Loukil,
  3. L Sfaihi,
  4. S Ben Ameur,
  5. TH Kamoun,
  6. M Hachicha
  1. Pediatrics Department, Hedi Chaker Hospital, Sfax, Tunisia

Abstract

Background and aims Neonatal bacterial meningitis (NBM) is a serious disease with high morbidity and mortality rates.

Aims Study the epidemiological, clinical, bacteriological aspects and the outcome of NBM.

Methods We 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.

Results The 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%.

Conclusion This 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.

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