Correlation of Bacteremia in Neonates with Bacterial Meningitis

Amber Azim¹, Gopa Banerjee¹*, Amita Jain¹, Vimala Venkatesh¹, Nishtha Singh¹, Mala Kumar² and Shalini Tripathi^2
1Department of Microbiology, King George’s Medical University, Lucknow, India
²Department of Pediatrics, King George’s Medical University, Lucknow, India
*Corresponding Author: Gopa Banerjee, Department of Microbiology, King George’s Medical University, Lucknow, India.

Published: June 20, 2023

DOI: 10.55162/MCMS.05.137

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Abstract  

Introduction: Meningitis is a critical condition involving most commonly neonates due to their immature immune system and greater permeability of blood brain barrier. Symptoms in neonatal meningitis are nonspecific and its long term complications could be deafness, blindness, cerebral palsy, seizures, hydrocephalus, or cognitive impairment. Therefore evaluation of the neonate should involve a high level of suspicion of meningitis to provide its early diagnosis and quick initiation of treatment.

Method: 244 neonates were enrolled whose blood and CSF samples were collected. CSF was cultured and incubated at 37 °C for 72 hours. Blood culture bottles were loaded in Automated Bact-alert 3D machine for maximum 5 days. Identification of microorganism by MALDI-TOF VITEK MS was done.

Results: Out of total 244 neonates enrolled, 153 cases were sterile on both CSF and Blood cultures. 56 CSF samples were found positive on culture, 30 were simultaneously positive for blood culture in which 26 had similar microorganism and 4 had different bacteria. Rest 26 blood cultures were sterile that indicates in 46.4 % of culture proven meningitis patients, there was no bacteremia.

Conclusion: There was a significant percentage of neonates reported with meningitis in whom blood culture was sterile. The signs and symptoms of meningitis are very subtle and vague in neonates. Therefore in neonates with symptoms of infection, one should always go for lumbar puncture for CSF culture along with other parameters. Meningitis, specially in neonates, should not solely be suspected in cases with positive blood culture as this could result in missing the diagnosis.

Meningitis, specially in neonates, should not be suspected only in cases with positive blood culture as this could result in missing the diagnosis.

Keywords: Neonatal meningitis; CSF culture; Blood culture; Bacteremia