Neonatal Meningitis in Nigerian Infants

Abstract

53 Nigerian infants with neonatal meningitis were prospectively studied. The striking features were: (a) the higher predisposition (26.7-fold) of LBW infants to developing meningitis than has been previously reported in the literature; (b) the predominant role of E. coli and Staphylococcus aureus; and (c) the rarity of salmonella organisms and the conspicuous absence of group B streptococcus as aetiological pathogens. The outcome was related to the age of onset and type of micro-organism. The presence of neurological signs, particularly nuchal rigidity and bulging anterior fontanelle, carried a poor prognosis. The overall mortality was 37.7%.

Neonatal bacterial meningitis in North Africa

“…Staph. aureus accounted for 55.5% of the gram positive organisms and is comparable to reports from Nigeria [8]. The incidence of pneumococcal meningitis (5.3%) was low compared to that reported in South African infants (25%) [9].…”

“…Lowbirth-weight infants had 10.1 times higher risks to develop meningitis (16.6 per 1000) than full-term newborns (1.64 per 1000). The overall incidence of 1.97 per 1000 live births was higher than fig- ures reported from Nigeria (0,69 per 1000) [8] and North America (0.4-0.46 per 1000) [6,11]. The higher incidence may be due to the increased number of high-risk births (20.6%) [10] and nosocomial infections with Klebsiella.…”

“…Bacteriological data are summarized in the table. The frequency of gram negative bacteria was 70.6% and as such much higher than in earlier studies (51%-52%) [8,11]. Klebsiella species was the predominant pathogen (38%) in contrast to E.coli elsewhere [4,8,11].…”

“…There are few studies, mainly from West [8] and South Africa [91 which have emphasized the distinctive features of meningitis in African neonates as compared to their counterparts from North America and Europe [6,11]. We wish to communicate our experience of 75 infants with neonatal meningitis from a North African country ( Table 1).…”

Etiological patterns of bacterial meningitis in neonatal sepsis

“…5 Reports from poor and developing countries, like Nigeria and Ethiopia, showed Gram negative organisms, such as E. coli, Klebsiella, and Enterobacter were the top agents that cause neonatal meningitis. 12,13 In other developing countries, such as Panama and Haiti, although Gram negative organisms (E. coli, Klebsiella, Enterobacter, Serratia, and Pseudomonas) were still in the top charts for causing neonatal meningitis, the incidence of GBS infection tends to increase. 14,15 All studies above reported the same results, organisms that cause sepsis are almost identical with organisms that cause meningitis.…”