Etiology of bacterial meningitis in newborns

 The causes and incidence of bacterial meningitis are closely related to age and whether infants have received routine immunizations. In children who have not received routine immunizations, common causes of bacterial meningitis include:

- S. pneumococcus (S. pneumoniae)

- Neisseria meningitidis

- H. influenzae type b

Other causes of bacterial meningitis in infants and children > 3 months of age have been reported but are rare. Staphylococcus aureus meningitis can occur in infants who have suffered trauma or neurosurgery.

Course of meningitis

 According to Dr. Truong Huu Khanh, Vice Chairman of the Ho Chi Minh City Federation of Infectious Diseases Association: "Bacteria and viruses that cause meningitis can invade, remain in the respiratory system for a long time, when encountering favorable factors to attack the cerebrospinal fluid cavity, causing inflammation and damage to the nervous system,  causing a high mortality rate and leaving severe sequelae of movement and cognition such as: such as deafness, blindness, epilepsy, weakness of limbs, psychomotor retardation ..."

Meningitis is usually transmitted through the respiratory tract, when a healthy person comes into contact with or inhales droplets from an infected person carrying the pathogen. In particular, close contact behaviors such as hugging and kissing, not wearing a mask when sneezing, ... easy to spread viruses, bacteria that cause meningitis.

"The weather in 3 regions in our country is in the transition period, heat alternates heavy rains, families with small children, the elderly, people with underlying medical conditions need to be wary of meningitis. This is a very serious disease, requiring emergency treatment. Many parents take the signs lightly, taking their children to the doctor late. In particular, self-use of antibiotics makes children's illnesses worse. 60-80% of hospitalized children have been given antibiotics by their parents," Dr. Truong Huu Khanh recommended.

Depending on the causative agent, the incubation period for meningitis varies, usually from 2 to 10 days, usually 3 to 4 days. Signs of meningitis that appear suddenly are fever, severe headache, neck stiffness, body sensitivity to light, loss of appetite, poor feeding, digestive disorders such as diarrhea or vomiting, cough, runny nose ... This manifestation is often easily confused with other common pathologies. Therefore, it is necessary to closely monitor, take children and adults to the hospital immediately, have accurate diagnostic tests and timely treatment.

How long does meningitis take to be treated?

 If meningitis is detected early, diagnosed and treated appropriately, the disease can be completely cured, without affecting long-term health. It should be noted that the timing of detection of the disease and active treatment are important factors affecting the duration of treatment.

In case the patient has severe meningitis, there are many complications accompanied by weakened health status, poor response to treatment will require a longer treatment time. Once the disease is under control and related damage is treated, the person can be discharged, self-medicated, and monitored at home.

Principles of antibiotic selection

 The principle of antibiotic selection in the optimal treatment regimen for purulent meningitis includes the following factors:

Early and as soon as possible: Use intervening antibiotics as soon as diagnosis is made.

- Reasonable: Predict bacteria to select effective antibiotics.

- Antibiotics must cross the blood-brain barrier.

- Bactericidal antibiotics that reach bactericidal concentrations must always be administered intravenously.

In particular, the problem of initial antibiotic selection (when there are no results of microbiological isolation) often has to be based on experience, age, favorable factors ... to orient pathogenic bacteria and use broad-spectrum antibiotics. Ceftriaxone is a preferred antibiotic used in the treatment of bacterial meningitis.

Source: https://vnvc.vn/dieu-tri-viem-mang-nao-mu/

By Geoffrey A. Weinberg, MD, Golisano Children's Hospital

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