| Objective:To understand the clinical characteristics of neonatal meningitis caused by group B streptococcus and Escherichia coil,and to compare whether there are differences,and provide a reference for more effective clinical treatment.Methods:neonatal department of the Children’s Hospital of Zhejiang University for retrospective analysis.According to different pathogenic bacteria,they were divided into S.agalactiae meningitis group and E.coli meningitis group.The gender,age of onset,pregnancy pattern,birth weight,main clinical manifestations,blood related laboratory test results,cerebrospinal fluid related results,complications,hospital stay,and prognosis of the two groups of children were collected.Comparing whether there are differences between the two groups can help us make clinical decisions.Results:1. Clinical manifestations:Fever(72 cases)is the most common in the two groups of children.Other clinical manifestations include eating less,crying and moving less (23 cases),convulsions(9 cases),bloating,diarrhea,and blood in the stool(4 cases),provoke(3 cases),moan(4 cases),jaundice(11 cases),scalp skin redness and scalp abscess(2 cases),left leg swelling(1 case).There was no statistically significant difference in these symptoms. 2. Examination of blood routine and inflammation indicators:In 81.5%of the cases,the high-sensitivity C-reactive protein exceeded 8 mg/dl,and the two groups had statistically significant differences in the number of leukocytes in the blood routine (P<0.05).3. Cerebrospinal fluid examination:The first cerebrospinal fluid examination of the two groups of children after admission was mostly manifested by increased white blood cell counts,increased protein concentration,and reduced sugar content.There was a statistically significant difference in white blood cell counts between the two groups(P<0.05).4. Skull MR examination and prognosis:the MR of the brain in 7 cases showed cerebral softening,7 cases with subdural effusion,6 cases with hydrocephalus,4 cases with intracranial hemorrhage,3 cases with ventricular meningitis and pulmonary emphysema,1 case with bilateral basal ganglia abnormalities,severe brain injury manifestations,.A total of 15 patients were automatically discharged, 65 patients were discharged after treatment.According to GOS scores,42 cases have good prognosis,38 cases have poor prognosis.There were no differences between groups in terms of skull MR changes,prognostic scores,and average hospital stay.5. Risk factors for prognosis:there are statistical differences between the group with good prognosis and the group with poor prognosis in gestational age{group with good prognosis(37.95±2.09)weeks vs group with poor prognosis(39.04±1.51)week P=0.021},the number of white blood cells in cerebrospinal fluid {good prognosis group 990(172 5500)×10~6/L vs poor prognosis group 3076(2029 7880)×10~6/L P=0.039},protein concentration{good prognosis group 1732(1257 2446)mg/L vs poor prognosis group 3076(2029 5048)mg/L P<0.001},glucose concentration{good prognosis group(1.68±1.14mmol/L)vs poor prognosis group(1.09±1.11)mmol/L P=0.033}。Conclusion:The data collected this time show that in the neonatal Escherichia coli meningitis group and the Streptococcus agalactia meningitis group,there were no statistical differenses in the gender,age of onset,gestational age,pregnancy pattern,birth weight,blood platelet count,hemoglobin concentration,protein concentration,glucose content in cerebrospinal fluid.There were only statistical differences in blood routine leukocytes,and leukocytes in cerebrospinal fluid(P<0.05).Therefore,early CSF culture and empirical selection cover is important.In this study,gestational age,cesarean delivery,increasing white blood cell count,high protein concentration,and low glucose concentration in CSF are risk factors for poor prognosis. |
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