[Bacterial meningitis in newborn infants. A retrospective study from a pediatric clinic 1967-1978].

A total of 22 newborn infants (14 boys, 8 girls) have been admitted and treated for bacterial meningitis in the University Pediatric Service of Geneva over a period of 11 years (May 1967 to May 1978). The three most common infectious agents were: Group B beta-hemolytic Streptococcus (6/22 cases), Escherichia coli (6/22 cases), and Listeria monocytogenes (4/22 cases). Thirteen of the 22 infants died (a 59% mortality, in keeping with that observed in other centers). Follow-up of the nine survivors showed a relatively favorable course from a developmental and neurological point of view. Only two of the infants have significant sequelae. Factors predisposing toward the occurrence of neonatal meningitis are a small birth weight, premature rupture of the membranes, and perinatal maternal infection. Prevention of neonatal meningitis is therefore very much dependent upon good perinatal care of the mother. Treatment of neonatal meningitis is impaired by the poor diffusion of antibiotics through the blood-brain barrier. Intrathecal antibiotics were used in 4 cases in this series, and three of these 4 patients died: intrathecal antibiotherapy is obviously not a good solution. Molecules with a better diffusion such as chloramphenicol should be considered with renewed interest.