Etiological patterns of bacterial meningitis in neonatal sepsis
Keywords:
bacterial meningitis, neonates, neonatal sepsis
Abstract
Background Sepsis and meningitis are major causes of mortalityand morbidity in neonates. The prevalence of sepsis is around 1-4
out of every 1000 live births, and one-fourth is accompanied by
meningitis. These numbers are higher in prematures.
Objective To find out the prevalence and etiological patterns of
bacterial meningitis in neonatal sepsis, and the pattern of antibi-
otic susceptibility for organisms causing bacterial meningitis.
Methods This was a cross sectional study, conducted in the neo-
natal ward and emergency room at Cipto Mangunkusumo Hospi-
tal from October 2003 to October 2004.
Results Seventy two neonates fulfilled the inclusion criteria and
were examined for blood and cerebrospinal fluid (CSF) cultures.
Sixty out of 72 neonates were proven for sepsis. Bacterial menin-
gitis was found in 18 neonates, and all cases were accompanied
by sepsis. Positive CSF cultures were found in 12 neonates. The
other six were diagnosed based on CSF cell count >32/μl.
Acinetobacter calcoaceticus was the major causative organisms
in this study. The organisms were highly resistant to first line anti-
biotics, except for chloramphenicol. They were also sensitive to
ceftazidime (second line), meropenem, and imipenem.
Conclusions The prevalence of bacterial meningitis in neonatal
sepsis at Cipto Mangunkusumo Hospital was 18/60 in 2003-2004.
The major causative organism was Acinetobacter calcoaceticus.
Antibiotic resistance was very high and only chloramphenicol,
ceftazidime, meropenem, and imipenem remain effective
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born infant. Inf Dis Clin North Am 1999;13:711-33.
3. Smith JB. Bacterial and fungal infection in the neo-
nate. In: Pomerance JJ, Richardson CJ, editors. Neo-
natology for clinician. Connecticut: Appleton & Lange;
1993. p. 185-200.
4. Holt DE, Halket S, de Louvois J, Harvey D. Neonatal
meningitis in England and Wales: 10 years on. Arch
Dis Child Fetal Neonatal 2001;84:85-9.
5. Chang CJ, Chang WN, Huang LT, Chang YC, Hung
PL, Tasi CY, et al. Neonatal bacterial meningitis in
Southern Taiwan. Pediatr Neurol 2003;29:288-94.
6. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo
WA, Ehrenkranz RA, et al. Tap or not to tap: High
likelihood of meningitis without sepsis among very low
birth weight infants. Pediatrics 2004;113:1181-6.
7. Wiswell TE, Baumgart S, Gannon CM, Spitzer AR.
No lumbar puncture in the evaluation for early neo-
natal sepsis: Will meningitis be missed? Pediatrics
1995;95:803-6.
8. Nel E. Neonatal meningitis: Mortality, cerebrospinal
fluid, and microbiological findings. J Trop Pediatr
2000;46:237-9.
9. Polk DB, Steele RW. Bacterial meningitis presenting
with normal cerebrospinal fluid. Pediatr Infect Dis J
1987;6:1040-2.
10. Heath PT, Yusoff NKN, Baker CJ. Neonatal meningi-
tis. Arch Dis Child Fetal Neonatal Ed 2003;88:73-8.
11. Gerdes JS. Diagnosis and management of bacterial in-
fections in the neonate. Pediatr Clin North Am
2004;51:939-59.
12. Longe AC, Omene JA, Akolo AA. Neonatal meningi-
tis in Nigerian infants. Acta Paediatr Scand 1984;477-
81.
13. Gebremariam A. Neonatal meningitis in Addis Ababa:
A 10-year review. Ann Trop Paediatr 1998;18:279-83.
14. Moreno MT, Vargas S, Poveda R, Saez-Llorens X. Neo-
natal sepsis and meningitis in developing Latin Ameri-
can country. Pediatr Infect Dis J 1994;13:516-20.
15. Desinor OY, Silva JLZ, Menos MJD. Neonatal sep-
sis and meningitis in Haiti. J Trop Pediatr 2004;50:
48-50.
16. Rohsiswatmo R, Aminullah A, Amir I, Situmeang E,
Suradi R. Etiology of early and late onset sepsis in Cipto
Mangunkusumo general hospital. In: Santoso H,
Suwendra P, Suparyatha IBG, Winata IGK, editors.
Proceedings of the 12th National Congress of Child
Health; 2002 June 30-July 4, Bali, Indonesia.
17. Pohan SA. Biakan dan uji kepekaan kuman dari AKDR
peserta keluarga berencana [thesis]. Jakarta: Depart-
ment of Obstetrics and Gynaecology, Medical School,
Univ. Indonesia. 1986.
18. Natadisastra K. Pemeriksaan jenis kuman aerob pada
persalinan [thesis]. Jakarta: Department of Obstet-
rics and Gynaecology, Medical School, Univ. Indo-
nesia. 1979.
19. Isaacs D. Rationing antibiotic use ini neonatal units.
Arch Dis Child Fetal Neonatal Ed 2000;82:1-2.
20. Gotoff SP. Neonatal sepsis and meningitis. In: Behrman
RE, Kliegman RM, Arvin AM, editors. Nelson text-
book of pediatrics. 15th ed. Philadelphia: WB Saunders
Company; 1996. p. 528-37.
Published
2016-10-18
How to Cite
1.
Setiawan A, Amir I, Tumbelaka A. Etiological patterns of bacterial meningitis in neonatal sepsis. PI [Internet]. 18Oct.2016 [cited 24Apr.2024];46(1):32-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/851
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Received 2016-10-10
Accepted 2016-10-10
Published 2016-10-18
Accepted 2016-10-10
Published 2016-10-18
