ABSTRACT
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.
Subject(s)
Humans , Female , Pregnancy , Adult , Fetal Membranes, Premature Rupture , Infectious Disease Transmission, Vertical , Meningitis, Escherichia coli/diagnosis , Meningitis, Escherichia coli/transmission , Obstetric Labor, Premature , beta-Lactamases/biosynthesis , Escherichia coli/enzymology , Escherichia coli Infections/diagnosis , Escherichia coli Infections/transmissionABSTRACT
We reviewed the charts of all patients > or = 15 years of age or older in whom community acquired-bacterial meningitis was diagnosed at Srinagarind Hospital, Khon Kaen, Thailand from 1984 through 1998. Eighty-five patients were included in this study. The clinical manifestation was acute meningitis with CSF neutrophilic pleocytosis and low glucose content. Gram's staining of CSF was positive in 79%. The most common pathogens were Streptococcus pneumoniae (28%) and Escherichia coli (14%) respectively. The overall mortality was 34%.