Neonatal meningitis

Objective: To determine the prevalent bacterial agents of neonatal meningit is and their antibiotic susceptibility in a referral intensive care unit in Assir Central Hospital, Saudi Arabia, during the years 1993-1998. Methods: Records of newborn infants with positive cerebrospinal fluid cultu re during the period were retrospectively studied. Results: Then were 1473 nursery admissions, of which 32 episodes of meningi tis occurred amongst 31 neonates, Klebsiella pneumoniae (31%) and Serratia marcescens (21%) were the main pathogens. The incidence of concurrent septi cemia among these infants was 58%. Klebsiella pneumoniae appears to dominat e in both early and late onset infections. The sex incidence was equal and the mortality rate was 48%. Conclusion: The survey pneumoniae and Serratia sp. identifies Klebsiella as the tending bacterial agents of neonatal meningitis in our environment. Th e relatively high frequency of Serratia infection in the present survey app ears unique as this organism is comparatively rare in ether reports across the globe, No Group B Streptococcus was isolated, which is in contrast to r eports obtained in Europe, America and Australia where it is the predominan t organism of neonatal sepsis or meningitis, Antibiogram identified imipene m and cefotaxime as the empirical antibiotics in infants with a clinical di agnosis of neonatal sepsis in our hospital; no more conventional use of amp icillin. In view of the changing bacterial pattern of infant infection with time even in the same environment, a periodic review of this subject is ad vocated.