2005, Number 1
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Perinatol Reprod Hum 2005; 19 (1)
Identification of clinical and laboratory markers in new born of preterm with diagnosis of bacterial neonatal meningitis
Reyna-Figueroa J, Ortiz-Ibarra FJ, Castro-Melchor L, Limón-Rojas AE
Language: Spanish
References: 29
Page: 22-30
PDF size: 95.36 Kb.
ABSTRACT
Objective: To find the association between the of clinical manifestations and the values of laboratory in new born preterm infants with diagnosis of neonatal bacterial meningitis.
Material and methods: We studied new born preterm with sepsis and diagnosis of meningitis (cases) and to newborn with sepsis without meningitis (controls) the information was obtained from department of infectology from Instituto Nacional de Perinatología (INPer). We found clinical manifestations and values of laboratory, including: cytoquimical and cytological analysis of cerebrospinal fluid (CSF), hematic biometry and chemical sanguineous.
Results: A total of 300 newborns were studied: 150 to controls and 150 cases. The clinical manifestations that showed statistical significance were: Abdominal distension (OR 2.5; IC 95% 1-7; p‹ 0.05); marmoreal skin (OR 6.6, IC95% 1.6-30,p ‹ 0.05), bleeding (OR 8.1, IC 95% 2 –18; p‹ 0.05); and metabolic acidosis (OR 8.1; IC 95% 5-18; p ‹ 0.05). The numbers of total cells, polimorfonuclear cells and mononuclear cells in cerebrospinal fluid and percent of reticular forms in hematology results were significant.
S. epidermidis was the microorganism found most frequently in the CSF.
Conclusions: Abdominal distention, bleeding and hypoglycemic had a significative association with meningitis. The analysis of cerebrospinal fluid is a necessary tool to neuroinfection diagnosis.
REFERENCES
Gold R. Epidemiology of bacterial meningitis. Infect Dis Clin North Am 1999; 3: 515-25.
Bale JF, Murph JR. Infections of the central nervous system in the newborn. Clin Perinatol 1997; 24: 787-806.
Feigin DR, McCracken HG, Klein OJ. Diagnosis and management of meningitis. Pediatr Infect Dis J 1992; 11: 785-814.
Klein OJ. Bacterial sepsis and meningitis. In: Remington JS, Klein JO (eds.). Infectious diseases of the fetus and newborn infant. 5th ed. Philadelphia: WB Saunders; 2001; 21: 550-3.
Harvey D, Holt ED, Bedford H. Bacterial meningitis in the Newborn: a prospective study of mortality and morbidity. Semin Perinatol 1999; 3: 218-25.
Feigin RD, Pearlman E. Bacterial meningitis beyond the neonatal period. In: Feigin RD (ed.). Textbook of pediatric infectious diseases. 4th ed. WB Saunders; 1998, p. 400-30.
Polin RA, Harris MC. Neonatal bacterial meningitis. Semin Neonatal 2001; 6: 157-72.
Chang HY, Chui NC, Huang FY. Characteristics of neonatal bacterial meningitis in a teaching hospital in Taiwan from 1984-1997. J Microbiol Immunol Infect 2000; 33:100-4.
Kumate J. Meningoencefalitis bacteriana. En: Kumate J, Gutierrez G (eds.). Manual de Infectología Clínica. 15 ed. México, D.F.: Méndez Editores; 1998, p. 185-92.
Holt DE, Halket S, de Louvois J, Hayvey D. Neonatal meningitis in England and Wales: 10 years on. Arch Dis Child Fetal Neonatal 2001; 84: 85-9.
De Louvois J, Blackbourn J, Hurley R. Infantile meningitis in England and Wales. A two year study. Arch Dis Child 1991; 666: 603-7.
De Louvois J. Acute bacterial meningitis in the newborn. J Antimicrob Chemother 1994; 34: 61-73.
Sheta KS, Murthy R, Shivananda PG. Incidence of meningitis in Manipal. Indian J Public Health 1999; 43: 82-4.
Dawson GK, Emerson CJ, Burns LJ. Fifteen years of experience with bacterial meningitis. Pediatr Infect Dis J 1999; 18: 816-22.
Reyna FJ, Ortiz IFJ, Plazola CNG, Limón RAE. Meningitis bacteriana en el recién nacido. Experiencia en el Instituto Nacional de Perinatología de 1990 a 1999. Bol Med Hosp Infant Mex 2004; 61: 402-11.
Nel E. Neonatal meningitis. Mortality, cerebrospinal fluid, and microbiological findings. J Trop Pediatr 2000; 46: 237-9.
Johnson CE, Whitwell JK, Pethe K, Saxena K, Super DM. Term newborns who are at risk for sepsis: are lumbar punctures necessary? Pediatrics 1997; 99: 76-80.
Klinger G, Chin NC, Beyene J, Perlman M. Predicting the outcome of neonatal bacterial meningitis. pediatrics 2000; 3: 477-82.
Zanelli S, Gillet Y, stamm D, Lina G, Floret D. Bacterial meningitis in infants 1 to 8 weeks old. Arch Pediatr 2000; 7: 565s-71s.
Ahmed A, Hickey MS, Ehrett S, Trujillo M, Brito F, Goto C. Cerebrospinal fluid values in the term neonate. Pediatr Infect Dis J 1996; 15: 298-303.
Baziomo JM, Krim G, Kremp O, Leke L, Mahomedaly H, O´Cheik A, Retospective analysis of 1331 samples of cerebrospinal fluid in newborn infants with suspected infection. Arch Pediatr 1995; 2: 833-9.
Schrang SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB, et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 2000; 6: 15-20.
Ríos Rem, Ruiz GL, Murguia DT. Meningitis bacteriana neonatal en un centro de tercer nivel. Rev Invest Clin 1998; 50: 31-6.
Hristeva L, Booy R, Bowler I. Prospective surveillance of neonatal meningitis. Arch Dis Child 1993; 69: 14-8.
Overall JC. Neonatal bacterial meningitis. J Pediatr 1970; 76: 499-511.
Wiswell TE, Baumgart S, Gannon CM, Spitzer AR. No lumbar puncture in the evaluation for early neonatal sepsis: will meningitis be missed? Pediatrics 1995; 6: 803-6.
Gladstone M, Ehrenkranz AR, Edberg CS, Baltimore SR. A ten year review of neonatal sepsis and comparison with the previous fifty-year experience. Pediatr Infect Dis J 1990; 9: 819-25.
Daoud AS, Sheyyab AM, Eksteish AF, Obeidat A, Ali AA, El Shanti H. Neonatal meningitis in Northern Jordan. J Trop Pediatr 1996; 42: 267-70.
Olmedo DI, Pallas AC, Miralles MM, Simon de HR, Rodríguez OJ, Chasco IA. Neonatal meningitis: study of 56 cases. An Esp Pediatr 1997; 46: 189-94.