Progress of neonatal infection with Elizabethkingia anophelis / 国际儿科学杂志

Elizabethkingia anophelis is one of the most significant pathogens threatening human health.As an important opportunistic pathogen, it is prone to nosocomial infection outbreaks, and can cause neonatal meningitis, especially in prematurity, seriously affecting the safety and quality of life of children.E.anophelis has the characteristic of multi-drug resistance, which brings great challenges to clinical treatment.E.anophelis was commonly misidentified as E. meningosepticum in previous reports.In fact, E.anophelis accounts for a significant proportion of Elizabethkingia infections, which needs more attention.This article reviews the epidemiology of E. anophelis, clinical features of neonatal infection, drug sensitivity, treatment and prevention, in order to provide reference for clinical diagnosis and treatment.

Meningitis neonatal precoz causada por transmisión vertical de Escherichia coli productora de beta-lactamasa de espectro extendido en parto prematuro con rotura prematura de membranas / Early neonatal meningitis caused by vertical transmission of extended-spectrum beta-lactamase-producing Escherichia coli in premature labor with premature rupture of membranes

Se comunica el caso de un recién nacido producto de un parto prematuro con rotura prematura de membranas, que desarrolló precozmente meningitis neonatal por Escherichia coli productora de beta-lactamasa de espectro extendido. Los cultivos en líquido céfalo raquídeo y sangre neonatal fueron tempranamente positivos para esta bacteria. No obstante no aislarse este microorganismo en la madre, los hallazgos de la biopsia placentaria y la precocidad de la infección neonatal son determinantes en señalar que se trató de infección intraamniótica con transmisión vertical al neonato. La meningitis neonatal fue tratada con meropenem y el niño se dio de alta en buenas condiciones después de 41 días de hospitalización. Las guías perinatales actuales, preconizan el tamizaje de muestras vaginales para la prevención del parto prematuro y de los resultados adversos asociados a infección bacteriana ascendente durante el embarazo.

We report the case of a newborn resultant of premature delivery with premature rupture of membranes, which developed early-onset neonatal meningitis caused by transmission of Escherichia coli producer of betalactamasa of spectrum extended. Cultures in cerebrospinal fluid and neonatal blood were early positive for this bacterium. Although this microorganism is not isolated in the mother, the findings of the placenta biopsy and the precocity of the neonatal infection are determinant in indicating that it was an intraamniotic infection with vertical transmission to the neonate. Neonatal meningitis was treated with meropenem and the child was discharged in good condition after 41 days of hospitalization. The current perinatal guidelines support the screening of vaginal samples for the prevention of preterm birth and the adverse outcomes associated with ascending bacterial infection during pregnancy.

Group B Streptococcal Meningitis in Neonate: 2001-2011 / 대한주산의학회잡지

PURPOSE: Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis. Little is known about neonatal GBS infection in Korea. We investigated the clinical characteristics of GBS meningitis in neonate. METHODS: We retrospectively analyzed 15 medical records of patients who diagnosed neonatal GBS meningitis admitted to two tertiary centers from January 2001 to December 2011. We analyzed the patient's characteristics, clinical symptoms and signs at admission, laboratory findings, and short-term outcomes at discharge. RESULTS: Among a total of 15 patients, five patients had early GBS meningitis and ten patients had late GBS meningitis. The most frequent clinical onset time was after three weeks of age. The major clinical symptom was respiratory difficulty in early GBS meningitis and fever in late GBS meningitis. The mortality rate was 6.7%. Among 15 patients, eight patients (53.3%) had abnormalities on neuroimaging studies at discharge and most of these patients were late GBS meningitis. CONCLUSION: Late GBS meningitis was the majority of neonatal GBS meningitis and had poor short-term neurological outcomes. To prevent the late GBS meningitis, we need to nation-wide preventive study including the incidence, mortality, and long-term outcomes of neonatal GBS meningitis.

Clinical outcome of neonatal bacterial meningitis according to birth weight

OBJECTIVE: To describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. METHOD: Eighty-seven newborns were studied. Thirty-four infants were low birth weight newborn and 53 presented birth weight > " 2500 g. The clinical data were obtained through the analysis of patientsÆ files. FisherÆs exact test, the c² and the Mann-Whitney test were applied. RESULTS: Neurological symptoms were more common in infants weighed > " 2500 g (p<0.05). Complications affected half of the cases in both groups. Complications affected half of the cases in both groups, with an overall mortality rate of 11.5 percent. CONCLUSION: The rate of complications was high in both groups, regardless of the birth weight. No association was observed between the occurrence of death and birth weight. Infants with positive CSF culture had a poorer prognosis.

OBJETIVO: Descrever a evolução clínica e as complicações da meningite bacteriana de acordo com o peso de nascimento em recém-nascidos admitidos em unidade de terapia intensiva externa durante o período de 11 anos. MÉTODO: Foram estudados 87 neonatos, dos quais 34 foram recém-nascidos de baixo peso e 53 apresentaram peso > " 2500 g. Os dados clínicos foram obtidos por análise dos prontuários médicos. Foram realizados teste exato de Fisher, teste do c² e teste de Mann-Whitney. RESULTADOS: Os sintomas neurológicos foram mais comuns em neonatos com peso > " 2500 g (p<0,05 ). As complicações ocorreram na metade dos casos em ambos os grupos, com mortalidade global de 11.5 por cento. CONCLUSÃO: A freqüência de complicações foi alta em ambos os grupos, independentemente do peso de nascimento. Não houve associação entre óbito e peso de nascimento. Os neonatos com cultura de líquor positiva apresentaram pior prognóstico.

A Case of Neonatal Sepsis with Meningitis due to Gardnerella vaginalis / 대한주산의학회잡지

Gardnerella vaginalis is a normal component of the vaginal flora and is one of the organisms associated with bacterial vaginosis. It is rarely involved in neonatal infection. Although it is possible that G. vaginalis plays an etiologic role in bacteremia, facial cellulitis and abscess, conjunctivitis, infected cephalhematoma, scalp abscess, respiratory disease and meningitis in newborns, G. vaginalis is an uncommon pathogen of neonatal sepsis and meningitis. We report a 3,830 g term neonate with sepsis and meningitis due to G. vaginalis and review the characteristics of neonatal G. vaginalis infection reported in the literatures.

Clinical Study on NeonataI Meningitis

A clinical study was made on 68 cases of neonatal meningitis occuring under the age of 1 month at the department of Pediatrics at Severance Hospital, Yonsei University College of Medicine from 1st Jan. 1965 to 31th Dec. 1981. The sex ratio of male to female was 1.8:1 approximately. Neonatal predisposing factors significantly associated with neonatal meningitis were omphalitis(14 cases), skin infection (13 cases), birth injury (9 cases) and pneumonia (8 cases) etc. The most common maternal predisposing factor was difficult labor (13 cases). In 27 out of the 68 cultured CSF, the most common organisms were E. coli (29.6%), Staphylococcus coagulase(+) (22.2%) and Beta meholytic streptococcus (22.2%). Gram negative organisms were found in 12 cases (44.4%). The most common presenting symptoms were non-specific in nature -an elevated or subnormal body temperature, convulsion, poor feeding, irritability, jaundice and vomiting in that order of frequency. The presence of a poor Moro reflex, neck stiffness, unconsciousness or convulsion correlated with the high mortality rate significantly. Complications and sequelae included convulsion(11 cases), subdural effusion (8 cases), candida infection (8 cases), hydrocephalus (2 cases) and cerebral hemorrhage (2 cases) in that order of frequency. In the 68 cases, there were 29 mortalities or 42.6%.

Clinical Study on Neonatal Meningitis

A clinical study was made on 58 cases of neonatal meningitis occuring under the age of 1 month in the department of Pediatrics at Severance Hospital, yonsei University College of Medicine, from Jan. 1, 1965 to Dec. 31, 1978. 1. The sex ratio of male and female was approximately 1.8:1. 2. Neonatal predisposing factors significantly associated with meningitis were omphalitis(14 cases), skin infection (11 cases), birth injury (9 cases), pneumonia(8 cases), etc. Most common maternal predisposing factors were difficult labor (12 cases). 3. In 25 out of the 58 cases cultered, the most common organism was E. coli(32%), next common Staphylococcus coagulase(+) (24%), followed by beta-Streptococcus (16%). 4. The most common presenting symptoms were nonspecific in nature-a elevated or subnormal temperature, poor feeding, irritability, jaundice and vomiting in order of frequency. 5. The presence of poor moro reflex, neck stiffness, unconsciousness, or convulsion correlated significantly with the high mortality rate. 6. Complications included subdural effusion(8 cases), convulsion(6 cases), Candida infection (6 cases), hydrocphalus(2 cases), and cerebral hemorrhage (2 cases) in order of frequency. 7. In the 58 cases there were 25 mortalities, or 43.1%.