Evaluation of Risk and Prognostic Factors in Neonatal Meningitis

Abstract

Introduction:Neonatal meningitis is one of the important causes of mortality and morbidity in newborns. In this study, it was aimed to examine the microbiological factors, biochemical and clinical characteristics of neonatal meningitis cases, to reveal the risk factors, and to investigate the effect on the morbidities associated with meningitis in the first year of life. Materials and Methods:The files of patients diagnosed with meningitis in the level 3 Neonatal Intensive Care Unit between January 2010 and December 2015 were retrospectively analyzed. Results: There were 118 patients diagnosed with meningitis. The median gestational age of the patients was 32 weeks (24-40 weeks), and the median birth weight was 1987 grams (690-5020 grams). Most of the meningitis patients (n=106, 90%) were with late sepsis. The diagnosis day of those with poor prognosis was found to be greater [9.7 (2-28) days to 15.5 (3-138) days, p=0.03]. Cerebrospinal fluid (CSF) leukocytes were significantly higher in term babies with abnormal cranial magnetic resonance imaging (MRI) findings (p=0.037) and loss in hearing tests (p=0.045). CSF sugar levels were significantly lower in preterm babies with neuromotor retardation (p=0.001), history of seizures (p=0.003), abnormal cranial MRI findings (p=0.008) and hearing loss (p=0.005). Conclusion:In the long term, a significant number of cases with neonatal meningitis have neuromotor retarda-tion and hearing problems. Factors that can be used as predictors for poor neurological development; late-onset day, increased CSF leukocyte in all babies, and decreased CSF sugar in preterm babies. ÖzGiriş: Menenjit, yenidoğanlarda önemli bir mortalite ve morbidite nedenidir. Bu çalışmada, yenidoğan menen-jitlerinin mikrobiyolojik, biyokimyasal ve klinik özelliklerinin incelenmesi ve yaşamın ilk yılındaki morbid-itelere etkili risk faktörlerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Ocak 2010-Aralık 2015 tarihleri arasında 3. Düzey Yenidoğan Yoğun Bakım Ünitesi'nde menenjit tanısı alan hastaların dosyaları geriye dönük olarak incelendi. Bulgular: Menenjit teşhisi konan 118 hasta vardı. Hastaların ortanca gebelik yaşı 32 hafta (24-40 hafta), ortanca doğum ağırlığı 1987 gram (690-5020 gram) idi. Menenjit hastalarının çoğu (n=106, %90) geç sepsis hastasıydı. Prognozu kötü olanların tanı günü daha fazla [9,7 (2-28) gün ile 15,5 (3-138) gün] olarak bulundu,