Is Bacterial Meningitis Associated with Specific Microorganism in Neonatal Sepsis?

Abstract

Background: Neonatal infections including meningitis are among the major reasons of neonatal death in the region. Timely and prompt diagnosis and treatment is required to prevent its complications. Aim of this study was to find out the association between etiological agents of meningitis and sepsis in neonates.

Methods: It was a cross sectional descriptive study done at Neonatology department, the Children’s Hospital Lahore, with effect from 1^st March till 31^st August 2018. One hundred and seventy-five neonates with blood culture positive sepsis were enrolled in the study. All patients underwent CSF tap. Thirteen neonates with congenital anomalies, deranged coagulation profile and surgical problems were excluded.  The information including age, gender, weight, type of microorganisms, CSF analysis and outcome of the patients was collected on a predesigned proforma. SPSS version 20 was used for statistical analysis to look for association between pathogens causing sepsis and meningitis. Significance was calculated by using Chi-square test and logistic regression methods. Significant p-value was less than 0.05.

Results: Total included neonates were 162. Male to female ratio was 2:1. EOS cases were 53 (32.70%) while LOS cases were 109 (67.30%). Gram negative microorganism was more common in both blood cultures (n=127, 78.39%) and CSF cultures (n=41 80.40%). Meningitis was found in 103/162 (63.5%) neonates.  A significant number of septic babies due to Pseudomonas, E. coli, Klebsiella and CONS were found to have meningitis.

Conclusions: Meningitis is common in blood culture positive sepsis due to Pseudomonas, E. coli, Klebsiella and CONS species.