Epidemiology of neonatal purulent meningitis in Hebei Province, China: a multicenter study

Abstract:

Objective To investigate the clinical characteristics, diagnosis and main pathogenic bacteria, and outcomes of neonatal purulent meningitis. Methods A prospective epidemiological study was conducted in neonates with purulent meningitis admitted to 23 cooperating hospitals between 2013 and 2014. Clinical data were collected and clinical characteristics and outcomes were analyzed. Results A total of 301 neonates with purulent meningitis from the 23 cooperating hospitals were included. Neonatal pneumonia was the most common primary disease (167 cases, 55.5%). Fever was the most common manifestation (214 cases, 71.1%). Blood culture findings were positive in 72 patients (23.9%), with Escherichia coli, Klebsiella pneumoniae and Staphylococcus epidermidis as the most common bacteria. Positive cerebrospinal fluid (CSF) culture was found in 36 patients (36/264, 13.6%), with Escherichia coli and Staphylococcus epidermidis as the most common bacteria. The median of CSF WBC counts was 80/mm³ (range: 0-9 2500/mm³), and 11 cases (3.7%) had CSF WBC counts of <20/mm³ and 154 cases (51.2%) had CSF WBC counts of >100/mm³. There were 258 patients (85.7%) who were cured or improved at discharge and 15 deaths (15/298, 5.0%). Conclusions The most common primary disease of neonatal purulent meningitis is neonatal pneumonia in this area. The patients with neonatal purulent meningitis most often present with fever. Escherichia coli is the leading pathogenic bacteria causing neonatal purulent meningitis. A normal CSF WBC count can barely be used to exclude the possibility of this diosorder.