ASSESSMENT OF NEONATAL MENINGITIS IN A UNIQUE PRESENTATION WITH SEPSIS

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Jahanzeb Khan Afridi
Rahida Karim
Muhammad Idrees
Shahrukh Yar
Gul e Lala
Huma Gul

Abstract

Objective: To assess meningitis in neonates presented with sepsis to a tertiary care hospital of the province Khyber Pakhtunkhwa.


Methodology: This hospital based cross sectional study was conducted at Department of Pediatrics, Hayatabad Medical Complex, Peshawar from 24th January 2021 to 24th July 2021. The neonates were enrolled through Out Patient Department (OPD) and Emergency Department (ER) with signs and symptoms that were suggestive of sepsis. The diagnosis was confirmed using lumber puncture investigation. The extracted data was then evaluated using SPSS v.24.0 for descriptive and inferential analysis.


Results: In total of 168 neonates with mean age of 13.36±9.26 days, 54.9% individuals were born full term, wherein 51.2% had decreased feed, 54.9% were lethargic, and 42.7% were hypothermic. In total, 57.3% had negative blood culture, while 52.4% were diagnosed to have meningitis. In addition, 61% of the neonates had raised Total Leukocyte Count (TLC), and 64% of the neonates had increased C-Reactive Protein (CRP) of more than 0.5mg/dl. Meningitis was found to have significant association (p<0.05) with gender, hyperthermia, decreased oral feed, lethargic condition, blood culture positivity and TLC while had an insignificant (p>0.05) relationship with hypothermia, age group and age at birth (grouped) and CRP levels.


Conclusion: The study concluded that more than half of the neonates presented with suggestive signs and symp­toms of sepsis were positive for meningitis. High number of neonates had increased TLC and CRP.

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1.
Jahanzeb Khan Afridi, Rahida Karim, Muhammad Idrees, Shahrukh Yar, Gul e Lala, Huma Gul. ASSESSMENT OF NEONATAL MENINGITIS IN A UNIQUE PRESENTATION WITH SEPSIS. J Postgrad Med Inst [Internet]. 2023 May 22 [cited 2024 Mar. 28];37(2):130-4. Available from: https://www.jpmi.org.pk/index.php/jpmi/article/view/3183
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References

Sharma CM, Agrawal RP, Sharan H, Ku¬mar B, Sharma D, Bhatia SS. "Neonatal Sepsis": Bacteria & their Susceptibility Pattern towards Antibiotics in Neonatal Intensive Care Unit. J Clin Diagn Res. 2013;7(11):2511-3. DOI: 10.7860/ JCDR/2013/6796.3594.

WHO. Newborns: reducing mortality: World Health Organization. Available from URL: www.who.int/news-room/ fact-sheets/detail/newborns-reduc¬ing-mortality.2017

Dapaah Siakwan F, Mehra S, Lodhi S, Mikhno A, Cameron G. White cell in¬dices and CRP: predictors of menin¬gitis in neonatal sepsis. Int J Pediatr. 2016;4(2):1355-64

Ku LC, Boggess KA, Cohen Wolkowiez M. Bacterial meningitis in infants. Clin Perinatol. 2015;42(1):29-45,vii-viii. DOI:10.1016/j.clp.2014.10.004.

Kohli Lynch M, Russell NJ, Seale AC, Dangor Z, Tann CJ, Baker CJ, et al. Neurodevelopmental Impairment in Children After Group B Streptococcal Disease Worldwide: Systematic Re¬view and Meta-analyses. Clin Infect Dis. 2017;65(suppl_2):S190-S199. DOI:10.1093/cid/cix663.

Gordon SM, Srinivasan L, Harris MC. Neonatal Meningitis: Overcoming Challenges in Diagnosis, Progno¬sis, and Treatment with Omics. Front Pediatr. 2017;5:139. DOI:10.3389/ fped.2017.00139.

Saleem S, Akbar N, Anwar A, Mehmood R. Frequency of meningitis in neonatal late onset sepsis in Gangaram hos¬pital, Lahore. Ann Punjab Med Coll. 2015;9(3):140-4.

Bhagat R, Hussain S, Gattoo I, Wani S. Incidence of meningitis in late on¬set sepsis. Int J Contemp Pediatr. 2015;2(2):96. DOI:10.5455/2349- 3291.ijcp20150507

Anwer SK, Mustafa S, Pariyani S, Ashraf S, TaufiqKM.Neonatal sepsis: an etio¬logic study. J Pak Med Assoc. 2000;50: 91-4.

Joshi SG, Ghole VS, Niphadkar KB. Neonatal gram-negative bacteremia. Indian J Pediatr. 2000;67(1):27-32. DOI:10.1007/BF02802632.

Bhutta ZA. Neonatal bacterial infec¬tions indeveloping countries: strate¬gies for prevention. SeminNeonatol. 1999;4:159-71.

Freedman RM, Ingram DL, Gross I, Eh¬renkranz RA, Warshaw JB, Baltimore RS. A half century of neonatal sepsis at Yale: 1928 to 1978. Am J Dis Child. 1981;135(2):140-4. DOI:10.1001/ archpedi.1981.02130260032010.

13. Goldstein B, Giroir B, Randolph A; In¬ternational Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: defini¬tions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005;6(1):2-8. DOI:10.1097/01. PCC.0000149131.72248.E6.

14. Bhagat R, Hussain S, Gattoo I, Wani S. Incidence of meningitis in late on¬set sepsis. Int J Contemp Pediatr. 2015;2(2):96. DOI:10.5455/2349- 3291.ijcp20150507

15. da Silva LP, Cavalheiro LG, Queirós F, Nova CV, Lucena R. Prevalence of newborn bacterial meningitis and sep¬sis during the pregnancy period for public health care system participants in Salvador, Bahia, Brazil. Braz J Infect Dis. 2007;11(2):272-6. DOI:10.1590/ s1413-86702007000200021.

16. Jiang JH, Chiu NC, Huang FY, Kao HA, Hsu CH, Hung HY, et al. Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset. J Microbiol Immunol Infect. 2004;37(5):301-6.

17. Laving AM, Musoke RN, Wasunna AO, Revathi G. Neonatal bacterial menin¬gitis at the newborn unit of Kenyat¬ta National Hospital. East Afr Med J. 2003;80(9):456-62. DOI: 10.4314/ eamj.v80i9.8742.

18. Wiswell TE, Baumgart S, Gannon CM, Spitzer AR. No lumbar puncture in the evaluation for early neonatal sepsis: will meningitis be missed? Pediatrics. 1995 Jun;95(6):803-6.

19. Visser VE, Hall RT. Lumbar puncture in the evaluation of suspected neonatal sepsis. J Pediatr. 1980;96(6):1063-7. DOI:10.1016/s0022-3476(80)80643- 3.

Tiskumara R, Fakharee SH, Liu CQ, Nuntnarumit P, Lui KM, Hammoud M, et al. Neonatal infections in Asia. Arch Dis Child Fetal Neonatal Ed. 2009;94(2):F144-8. DOI:10.1136/ adc.2008.139865.

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