Aletayeb Mohammad Hasan, Ahmad Farajzadeh Sheikh, Masood Dehdashtian
Neonatology Division, Emam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Pediatr Int. 2010 Jun;52(3):463-6. doi: 10.1111/j.1442-200X.2010.03107.x. Epub 2010 Feb 26.
Bacterial meningitis is a devastating infection with a high mortality rate, especially in neonates. The aim of this study was to determine the causative agents that cause bacterial meningitis in Khuzestan province in the south-western region of Iran.
A descriptive, cross-sectional study was carried out from 1997 to 2007 at the neonatal ward of a university teaching hospital (Emam Khomeini hospital) in Ahvaz. All infants younger than 29 days old who suffered from meningitis were included. Laboratory tests included Gram stain, culture, and biochemical tests. Cases were defined as meningitis if the cerebrospinal fluid culture was positive.
Based on cerebrospinal fluid culture, 31 infants were identified as having bacterial meningitis. Eleven (35.5%) of these cases were caused by Klebsiella pneumoniae, nine (29%) were caused by Enterobacter spp., three (9.6%) were caused by Escherichia coli, three (9.6%) were caused by Enterococcus spp., two (6.4%) were caused by Acinetobacter, and one case each (3.2%) was caused by Staphylococcus aureus, Pseudomonas aeruginosa and nontypeable Haemophilus influenzae. The male-to-female ratio was 2 : 1 (67.7% were male). The birthweights of 20 (64.5%) patients were under 2500 g and 11 (35.4%) patients had normal birthweights. Thirteen (42%) were early-onset cases and 18 (58%) were late-onset cases. More than half of the cases (54.8%) acquired the infection from the hospital. Blood cultures were positive for 18 (58%) patients. Thirty-two percent of cases died in spite of treatment.
Klebsiella pneumoniae and Enterobacter spp. were the two main causative agents that caused neonatal bacterial meningitis, and nosocomial meningitis was the most common type in our ward.
细菌性脑膜炎是一种具有高死亡率的毁灭性感染疾病，尤其是在新生儿中。本研究的目的是确定伊朗西南部胡齐斯坦省引起细菌性脑膜炎的病原体。
1997年至2007年在阿瓦士的一家大学教学医院（伊玛目霍梅尼医院）的新生儿病房开展了一项描述性横断面研究。纳入所有年龄小于29天且患有脑膜炎的婴儿。实验室检查包括革兰氏染色、培养及生化检测。若脑脊液培养呈阳性，则病例被定义为脑膜炎。
基于脑脊液培养，31名婴儿被确诊患有细菌性脑膜炎。其中11例（35.5%）由肺炎克雷伯菌引起，9例（29%）由肠杆菌属引起，3例（9.6%）由大肠埃希菌引起，3例（9.6%）由肠球菌属引起，2例（6.4%）由不动杆菌引起，金黄色葡萄球菌、铜绿假单胞菌和不可分型流感嗜血杆菌各引起1例（3.2%）。男女比例为2∶1（男性占67.7%）。20例（64.5%）患者出生体重低于2500g，11例（35.4%）患者出生体重正常。13例（42%）为早发型病例，18例（58%）为晚发型病例。超过半数的病例（54.8%）在医院获得感染。18例（58%）患者血培养呈阳性。尽管接受了治疗，仍有32%的病例死亡。
肺炎克雷伯菌和肠杆菌属是引起新生儿细菌性脑膜炎的两种主要病原体，医院感染性脑膜炎是我们病房最常见的类型。
