Etiology of Neonatal Meningits at a Tertiary Care Centre in North India

Amber Azim¹*, Gopa Banerjee¹, Amita Jain¹, Vimala Venkatesh¹, Prashant Gupta¹, Nishtha Singh¹, Mala Kumar² and Shalini Tripathi^2
1Department of Microbiology, King George’s Medical University
²Department of Pediatrics, King George’s Medical University
*Corresponding Author: Amber Azim, Department of Microbiology, King George’s Medical University.

Published: July 23, 2024

DOI: 10.55162/MCMS.07.228

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Abstract  

Introduction: Neonatal meningitis is a medical emergency having consistently high rate of mortality and morbidity in spite of leveled up vaccination, increased institutional deliveries with intrapartum prophylactic antibiotics and asepsis, and good hospital practices.

Material and Methods: Total 718 neonates were enrolled. CSF samples were cultured and read at 24, 48 and 72 hours. WBC Count of CSF of 30 / mm³ was considered cutoff to rule out possible contamination. Culture positive isolates were identified by MALDI-TOF VITEK MS. Antimicrobial susceptibility pattern was noted. PCR was done for atr gene of Streptococcus agalactiae of all culture negative samples.

Result: Out of 718 neonates enrolled 73 CSF were culture positive and 645 cultures were sterile. 5 isolates were probable contamination. Total 68 samples were positive with 63 bacterial isolates and 5 Candida species. Most commonly isolated bacteria were Acinetobacter spp (42%). and Klebsiella pneumoniae (15.9%). Among fungal isolates Candida albicans (4.4%) and Candida parapsilosis (2.9%) were isolated. PCR detected 2 cases of Streptococcus agalactiae causing meningitis.

Conclusion: Percentage positivity of bacterial and fungal meningitis was found to be 9.1 % and 0.7% respectively. Out of 68 samples, 51 had Gram negative and 12 had Gram positive bacteria on culture. Fungal isolates grew in 5 samples. Rare organism like Elizabethkingia anophelis (2.9 %), Chryseobacterium indologenes (2.9 %) Aerococcus viridians (1.4%) were isolated. PCR detected 2 cases of Streptococcus agalactiae (atr gene) of bacterial meningitis. Streptococcus agalactiae being a common etiology, had not been isolated in our cultures.

Keywords: Neonatal meningitis; Etiology; Antimicrobial Susceptibility Pattern; Risk Factors

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