Clinical Characteristics And Imaging Analysis Of Purulent Meningitis In Newborns Caused By Different Pathogens

Objective: To explore the related predictive factors for the occurrence of purulent meningitis and its recent poor prognosis by comparing the distribution of pathogens,clinical manifestations,main laboratory features,and imaging characteristics of children with different pathogenic purulent meningitis.The objective is to be able to diagnose and identify high-risk children early in the clinical diagnosis and treatment process,and provide a reference for timely treatment and improved prognosis.Methods: 1.Retrospective analysis was given by collecting the clinical data of children with purulent meningitis who were admitted to the neonatal ward of our hospital from February 2,2011 to October 12,2019.A total of 184 cases were included in the study.Blood culture and cerebrospinal fluid culture diagnosis were performed on all the children.The pathogenic bacteria detected by the first cerebrospinal fluid were divided into four groups: Escherichia coli group,Streptococcus agalactiae group,other pathogen group,and unknown pathogen group.A retrospective survey of the medical records was conducted to compare and analyze the general conditions,clinical manifestations,main laboratory features,and imaging features of the children.2.The distribution of pathogenic bacteria in children with neonatal purulent meningitis,the characteristics of laboratory examination,clinical characteristics and imaging characteristics of children with purulent meningitis caused by different pathogens were analyzed.Results: 1.A total of 79 pathogenic bacteria were detected in blood cultures of 184 neonates with purulent meningitis.The positive rate of pathogenic bacteria was 42.9%.A total of 40 pathogenic bacteria were detected in CSF culture.the Lord.2.Escherichia coli and Streptococcus agalactiae are the main pathogenic bacteria in term infants.Escherichia coli and Klebsiella pneumoniae are the major pathogens of sepsis in preterm infants.Streptococcus agalactiae accounts for a higher proportion of purulent meningitis in term infants(P<0.05),and Klebsiella pneumoniae accounts for a higher proportion of prematureinfants with purulent meningitis(P<0.05).2.Streptococcus agalactiae accounted for a higher proportion of purulent meningitis in term infants(P <0.05),and Klebsiella pneumoniae accounted for a higher proportion of children with purulent meningitis in preterm infants(P <0.05).3.There were no significant differences in gestational age,apgar 1-minute score,age of onset,gender,and birth pattern among children with different pathogenic purulent meningitis in the four groups(P> 0.05).4.The Hypersensitive C-reactive protein,cerebrospinal fluid total cell counts,cerebrospinal fluid sugar levels,and cerebrospinal fluid protein levels of the four groups of children were statistically significant(P <0.05);clinical manifestations of children with streptococcus bacillus group were prone to breathing and high apnea In the other three groups,the difference was statistically significant(P <0.05);the clinical manifestations of children in the Escherichia coli group were fever,convulsions,jaundice,and abdominal distension,which were higher than those in the other three groups.Statistical significance(P <0.05);Among the comorbidities in the four groups,the incidence of sepsis,hydrocephalus,and subdural abscess in the Escherichia coli group was higher than the other three groups,and the differences were statistically significant(P <0.05).5.The incidence of hydrocephalus in the Escherichia coli group was higher than the other three groups,and the differences were statistically significant(P <0.05);the incidence of white matter damage and meningeal fortification damage in the Streptococcus lactis-free group was higher than the other three groups,the differences There was statistical significance(P <0.05);the incidence of abnormal brain tissue signals in other bacteria groups was higher than the other three groups,and the difference was statistically significant(P <0.05).Conclusions: 1.The compositions of pathogenic bacteria causing purulent meningitis in term and preterm infants are different,which provides theoretical guidance on choosing antibiotics for early empirical treatment.2.There are differences in clinical manifestations,laboratory examinations and imaging findings in children with suppurative meningitis caused by different pathogens.It is suggested that there are individual differences in neonatal purulent meningitis,which provides an individualized diagnosis of neonatal purulent meningitis,and provides theoretical basis for individualized treatment.3.Comprehensive judgments should be combined with clinical characteristics and imaging characteristics,and targeted treatment should be given to reduce the mortality rate of neonatal suppurative meningitis.