Ku Lawrence C, Boggess Kim A, Cohen-Wolkowiez Michael
Department of Pediatrics, Duke Clinical Research Institute, Box 17969, Durham, NC 27715, USA.
Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, CB 7570, Chapel Hill, NC 27599-7570, USA.
Clin Perinatol. 2015 Mar;42(1):29-45, vii-viii. doi: 10.1016/j.clp.2014.10.004. Epub 2014 Dec 6.
Neonatal bacterial meningitis is uncommon but devastating. Morbidity among survivors remains high. The types and distribution of pathogens are related to gestational age, postnatal age, and geographic region. Confirming the diagnosis is difficult. Clinical signs are often subtle, lumbar punctures are frequently deferred, and cerebrospinal fluid (CSF) cultures can be compromised by prior antibiotic exposure. Infants with bacterial meningitis can have negative blood cultures and normal CSF parameters. Promising tests such as the polymerase chain reaction require further study. Prompt treatment with antibiotics is essential. Clinical trials investigating a vaccine for preventing neonatal Group B Streptococcus infections are ongoing.
新生儿细菌性脑膜炎虽不常见但极具破坏性。幸存者的发病率仍然很高。病原体的类型和分布与胎龄、出生后年龄及地理区域有关。确诊困难。临床症状往往不明显，腰椎穿刺常常推迟进行，脑脊液（CSF）培养可能会因先前使用抗生素而受到影响。患有细菌性脑膜炎的婴儿血培养结果可能为阴性，脑脊液参数也可能正常。诸如聚合酶链反应等有前景的检测方法还需要进一步研究。及时使用抗生素治疗至关重要。目前正在进行调查预防新生儿B族链球菌感染疫苗的临床试验。
