Objective To investigate the clinical characteristics of neonatal bacterial meningitis (NBM) and to identify the risk factors associated with complications,thereby providing evidence to support early identification and proactive treatment strategies. Methods A retrospective study was conducted on 83 neonates diagnosed with acute bacterial meningitis and admitted to our hospital's neonatal department between January 2013 and December 2023. Data were collected which were included gestational age,maternal pregnancy history,neonatal age,clinical symptoms,blood inflammation indicators[white blood cell count,neutrophil ratio,C-reactive protein,procalcitonin (PCT)],cerebrospinal fluid (CSF) analysis (white blood cell count,sugar,protein levels,and culture results),and head imaging findings[computed tomography,CT/magnetic resonance imaging (MRI)]. Results A total of 83 cases were diagnosed as NBM. Of these,75.90％ were full-term infants. The CSF culture results were negative in 59.1％ (49/83) and positive in 40.9％ (34/83) of the cases. Group B Streptococcus was the most common pathogen,accounting for 47.06％ (16/34) of all positive cultures,followed by Escherichia coli. Clinical symptoms of NBM were often atypical;fever,irritability,and respiratory distress were the most common initial symptoms,followed by poor feeding,decreased activity,and reduced crying. Based on head CT or MRI findings,the patients were divided into two groups:uncomplicated and complicated. The t-test was used to compare these groups and found statistical differences in fever,seizures,CSF white blood cell count,CSF protein levels,CSF glucose levels,and positive CSF culture rates. A logistic multivariate regression analysis was performed,including all variables and identified fever ≥39℃,seizures,increased CSF protein levels,and positive CSF cultures as independent predictors of complications in NBM (P<0.05). Conclusion The clinical manifestations of NBM frequently present atypical,making early diagnosis challenging. The most frequently identified pathogens are Group B streptococcus and Escherichia coli. The study identified several risk factors associated with complications in NBM,including a fever peak of 39℃ or higher,the occurrence of convulsions,an increased protein content in CSF and a positive CSF culture. These factors are determined to be independent predictors of complications through a logistic multivariate regression analysis,which can be crucial for guiding clinical management and treatment strategies in affected neonates.
万方数据
维普
