Evaluation of laboratory and imaging findings of newborn patients with the diagnosis of meningitis and the first 12 months' results

Neonatal meningitis is one of the important causes of mortality and morbidity in newborns. Mortality and long-term complication rates vary according to the time of diagnosis, the causative agent and the time of onset of treatment. Long term neurological sequelae, visual and auditory loss, cognitive and behavioral disorders can be seen. In this study, it was aimed to reveal the epidemiological and clinical characteristics and the results of the first year follow-up of the patients who were treated from diagnosis of meningitis in Neonatal İntensive Care Unit of Uludag University. Our study included patients who were diagnosed meningitis and hospitalized between January 2010 and December 2015 in Neonatal İntensive Care Unit of Uludag University. Patients' files were reviewed retrospectively. The epidemiological characteristics of the patients and follow-up data in the first year of life were evaluated. In the six-year period, 1360 patients were hospitalized with the diagnosis of neonatal sepsis. A total of 118 patients were diagnosed meningitis. Mean gestational ages of the patients were 32.7 weeks (24-40 weeks) and mean birth weight were 1987 gram (690-5020 gram). The rate of term patients was 25% and the rate of preterm patients was 75%. Mean diagnosis time was 11th day (2-40 day), mean hospital stay was 45 days (13-154 days). Patients who were diagnosed meningitis within early sepsis had a ratio of 10 (n:12) and within late sepsis had a ratio of 90 (n:106). In 17.7% of patients blood cultures and in 17.7% CSF (cerebrospinal fluid) cultures were positive. Staphylococcus Epidermidis was the most commonly produced microorganism in both cultures. Mortality rate was determined as 15.2% and pathology was found in cranial MR (magnetic resonance imaging) of 30% of discharged patients. The rate of patients with hearing problems in ABR (Auditory Brainstem Response) tests was 25% and 23% of patients had neuromotor retardation in their first year. In our study, risk factors in the diagnosis of meningitis were determined as male gender, prematurity, C/S (cesarean) birth, low birth weight (<2500 gram) and maternal PMR (premature membrane rupture) history. Microorganisms isolated in culture were found to be highly gram positive and similar to studies in developing countries. Findings supporting the availability of CSF findings were obtained in patients within non-isolated active culture was obtained. Poor prognosis in patients with meningitis was determined related with high CSF protein and CSF leukocyte count, low CSF glucose, low 5th minute APGAR score, seizure history and hearing loss. Data showing the effect of CSF findings on mortality and morbidity were similar in our study to the current studies. The rate of cases with meningitis accompanying late sepsis was found to be higher in patients with poor prognosis.