Clinical characteristics, pathogen distributions and outcomes of bacterial meningitis in preterm and term infants / 中国小儿急救医学

ABSTRACT

Objective:To investigate and compare the clinical characteristics, pathogen distributions and outcomes of bacterial meningitis in preterm and term infants.Methods:The data of 252 cases of neonatal bacterial meningitis hospitalized in Guangzhou Women and Children′s Medical Center from January 2013 to December 2018 were retrospectively analyzed and divided into two groups according to gestational age: preterm group( n=64)and term group( n=188). The clinical manifestations, laboratory examinations, pathogen distributions and clinical outcomes of the children in two groups were compared. Results:Fever was the most common clinical manifestation in both groups, but the incidences of lethargy, apnea and feeding intolerance in preterm group were significantly higher than those in term group( P<0.05). There was no significant difference in the rate of the first hemogram/cerebrospinal fluid abnormality between two groups( P>0.05). Sepsis, subdural effusion and hydrocephalus were the main complications in both groups.The incidence of complications in premature infants was 60.9%(39/64), which was significantly higher than that in full-term infants(44.7%, 84 /188) , with a statistically significant difference ( P<0.05). Escherichia coli and Streptococcus agalactiae were the most common pathogens in the preterm infants, whereas Klebsiella pneumoniae and Streptococcus agalactiae were the most common pathogens in the term infants.There was no statistical difference in the time of positive bacteria turning negative between two groups, but the course of antibiotics in preterm group was significantly longer than that in term group( P<0.05). The clinical cure/improvement rates in the two groups was about 95%, and the difference between two groups was not statistically significant( P>0.05). Conclusion:Early clinical manifestations of bacterial meningitis in preterm infants are atypical and relatively easy to be missed.The incidence of complications is significantly higher than that of full-term infants, and the duration of antibiotic use is longer.However, the clinical cure/improvement rate of premature infants is not worse than that of full-term infants after reasonable and standardized early treatment.