Clinical analysis of neonatal purulent meningitis caused by group B streptococcus / 中国小儿急救医学

ABSTRACT

Objective To explore the clinical characteristics and outcome of group B streptococcus (GBS) induced neonatal meningitis and to provide the guide for early diagnosis and appropriate treatment.Methods A retrospective chart review was performed.A total of 19 cases of neonatal purulent meningitis caused by GBS and 22 cases of neonatal purulent meningitis caused by Escherichia coli were identified in the NICU of Guangzhou Women and Children's Medical Center from Nov 1,2011 to Apr 31,2014.The clinical features,treatments and clinical turnover were analysed.Results GBS meningitis accounted for 24.7％ (19/77) of total bacterial positive cultures of blood or cerebral spinal fluid.The average time of progression to early-onset GBS meningitis of 6 early-onset cases mainly complaining of anhelation and groan,was (11.80 ± 11.34)h,and 83.3％ present within 24 hours;the main initial clinical symptoms of 13 late-onset cases[mean age (17.85 ± 7.77) d] were fever.Peripheral blood C-reactive protein concentration of GBS meningitis was significantly higher than that of Escherichia coli meningitis [(154.43 ± 88.64) mg/L vs.(67.52 ± 64.23) mg/L,P =0.001].Compared with Escherichia coli meningitis,the average length of stay in hospital and the recovery time of abnormal cerebral spinal fluid in neonates with GBS infection were both extended by more than 10 days.Conclusion The clinical manifestations of neonatal purulent meningitis caused by GBS are usually non-specific.It is associated with longer hospitalization and recovery time of abnormal cerebral spinal fluid.Antepartum prophylaxis,early diagnosis and therapy are vital for reducing the incidence of complications and mortality of neonatal GBS purulent meningitis.