WIP 80 - Short term clinical outcomes of Neonatal bacterial meningitis – A single centre Retrospective Cohort study

Publication Number: WIP 80.7651

Sowjanya VNS. Sivakoti, McMaster University Michael G. DeGroote School of Medicine, Hamilton, ON, Canada; Ipsita Goswami, McMaster University, Hamilton, ON, Canada; Shikha Gupta-Bhatnagar, McMaster Children's Hospital, Hamilton, ON, Canada; sarah Khan, McMaster University Michael G. DeGroote School of Medicine, Hamilton, ON, Canada

Background: Infection and inflammation are detrimental to developing brain leading to future neurological deficits. Clinical diagnosis and optimal antimicrobial therapy are challenging in critically ill neonates, associated with the risk of both over- and under-treatment.

Objective: To describe the clinical and neuro-imaging findings associated with adverse short-term clinical outcomes in a cohort of neonates with bacterial meningitis.

Design/Methods: Retrospective cohort study of neonates with bacterial meningitis within 44 weeks post-menstrual age between January 2017 to June 2023. Meningitis was defined by a pre-defined criteria based on cerebrospinal fluid (CSF) white-blood cell count and protein levels according to postnatal age and gestational maturity Primary outcome is any one of the following: Ventriculitis, brain abscess, hydrocephalus, relapse, periventricular leukomalacia and death within 30 days of diagnosis. Secondary outcomes include head ultrasound and MRI brain findings in the diagnosis and/or prognostication. Demographics, co-morbidities and clinical and laboratory findings ±3 days from meningitis episode are recorded. We enrolled 79 babies who met the inclusion criteria. Median (IQR) gestational age (wks) and birth weight (gms) were 30.57(11.57) and 1300 (1901) respectively. Median (IQR) day of diagnosis, duration of therapy and length of hospital stay were 6 (11), 21(14) and 49 (75). Most common blood pathogen was E Coli (25.64%). CSF was positive in 15.2%. Most common pathogen in the CSF was GBS (25%). The mean CRP was 80.2 ± SD 79.18. CSF biochemistry was done in 63 (80.76%) babies. Mean protein and WBC in CSF were 3.19±3.27 and 1316 ±3892. Most common presentation was apnoea/respiratory distress (59.7%). The relapse and death rate are 3.9% and 1.3%. We are in the process of reviewing brain images. Significance: We expect to characterize the clinical outcomes and abnormal radiological findings associated with meningitis and our findings will be highly relevant to understand the variability in management and identify gaps in care. Funding/acknowledgements: none