Retrospective Study on the Prevalence, Etiological Agents and Associated Risk Factors for Neonatal Meningitis Infection for the Last Ten Years(2001-2010) At Tikur Anbessa Specialzed Hospital, Addis Ababa, Ethiopia
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Date
2011-07
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Addis Ababa University
Abstract
Background: - Meningitis occurs more commonly during the first month of life (between birth and the first 28 days of life) than during any other subsequent period and it is associated with high morbidity and mortality. The causes of bacterial meningitis in the neonatal period are generally distinct from those in older infants and children and reflect the maternal gastrointestinal and genitourinary flora and the environment to which the infant is exposed. Data on the recent relative magnitude of the neonatal meningitis infection and associated risk factors is insufficient in Ethiopia.
Objective: - The aim of this study was to determine the prevalence, etiologic agents for neonatal meningitis infection and associated risk factors in Tikur Anbessa Specialized Hospital.
Methods: - This is a retrospective analysis of 2510 CSF and blood specimens submitted to the bacteriology laboratory of Tikur Anbessa Specialized Hospital for culture in the period between Jan, 2001 and Dec, 2010. The study was done from April, 15- June, 2011.
Result: - For this retrospective study data were obtain from 1321 males and 1189 females making male to female ratio 1.1:1. Of 2510 total culture 1321(52.63 %%) were from blood and 1189(47.37%) were from CSF. The causative agent had been isolated (414) showing an isolation rate of (16.49%) of the total 2510 meningitis suspected cases; 358(27.10%) were isolated from blood, while 56(4.71%) have been isolated from CSF culture. The numbers of bacterial meningitis cases in each year from 2001 to 2010 were 41, 18, 16,50,54,46,44,45,40 and 56, respectively and the positive isolation rates in the same year were 13.6%, 14.6%, 17.0%, 25.1%, 20.8%, 26.1%, 15.5%, 15.5%, 12.8% and 12.6% respectively. 56 (13.53%) of bacterial pathogen were isolated only in the year 2010. Higher peak had been observed from the year 2004 to 2006. Of 414 positive for neonatal bacterial meningitis cases; the most common isolated pathogens were Coagulase-negative-staph 148(35.75%), S.aureus 65(15.70%), K.pneumoniae 50(12.08%), Acinetobacter 45(10.87%), E.coli 28 (6.76%). Coagulase-negative-staphylococcus was the predominant pathogen accounting for 148(35.75%) of all cases. Whereas S.aureus and K.pneumoniae accounted for 65(15.70%), 50(12.08%) respectively: More than 50% of the pathogens were isolated from neonates having preterm birth and LBW. Of 75 positive cases that have been properly treated; 66(88%) were given a combination of ampicillin and gentamycin.
Conclusion:-Coagulase –negative-staphylococcus remains the major causative agent of neonatal bacterial meningitis infection in the study area. More than 50% were isolated from neonates having preterm birth and LBW; hence, preterm birth and LBW were major risk factors for neonatal bacterial meningitis infections.
Keywords:-Neonates, bacterial meningitis, coagulase-negative-staphylococcus
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Keywords
Neonates, Bacterial meningitis, Coagulase-negative-staphylococcus