NEONATAL MENINGITIS

Is defined as neonatal meningitis clinical situation characterized by signs and symptoms of systemic infection, inflammatory markers compatible (blood count, C-reactive protein (CRP), etc.) and changes in the cerebrospinal fluid (CSF) suggestive of meningeal inflammation (increased leukocyte and protein and decreased glucose) isolation of microorganisms not be indispensable. For the interpretation of the findings in the CSF should be borne in mind that in the neonatal period normally ranges are different to those found in infants and children, and also differences between newborns (RN) and term neonates.

Once the diagnosis is made and based on the results of microbiological analysis it is considered microbiologically proven meningitis when CSF culture positive for bacteria, viruses or fungi; microbiologically likely meningitis when CSF culture is negative and positive blood culture and meningitis microbiologically unproven when both cultures are negative. It is unclear why in the course of a few RN bacteremia develop meningitis and some not. Experimental studies postulate that the high number of bacteria that invade the bloodstream correlates with the likelihood of meningitis. It also relates to the characteristics of germs, and thus the capsular antigen of E. coli K1, which is similar to the capsular polysaccharide of N. meningitidis type B, it is important to promote the survival of the organism in the bloodstream and promote their step by the blood-brain barrier. Over 80% of neonatal meningitis E. sliding block caused by strains carrying this antigen. Similarly was separated ñalado in infections with S. agalactiae (GBS), an increased risk of developing meningitis when the infection is by biotypes B1 to B6 or importance of the type III capsular polysaccharide as a virulence factor in Late meningitis caused by this germ.

VERTICAL MENINGITIS

They are caused by germs initially localized in the maternal genital channel, via ascending or direct contact, first pollute the skin and / or respiratory mucosa and / or digestive fetus and then invade the bloodstream. MTCT risk factors obstetric those circumstances that are associated with a significant incidence of infection bacteriana6 considered: maternal vaginal colonization by pathogen, spontaneous preterm birth, chorioamnionitis, intrapartum fever, prolonged rupture of membranes, hypoxia, urinary tract infection at the end of the gestation, etc.

NOSOCOMIAL MENINGITIS

They are caused by germs located in the hospital environment (especially in the neonatal ICU) that first colonize the skin and / or mucous membranes, then through the cutaneous and mucosal barrier and invade the bloodstream and ultimately cross the blood barrier -encefálica and lead to meningitis. Risk factors are considered: enter the NICU, premature, after broad-spectrum antibiotics, use of central catheters to infuse intravenous feeding, intubation and mechanical ventilation, and in case of meningitis also matter congenital anomalies (meningocele, myelomeningocele, sinus dermicus, etc.) that favor the direct invasion of bacteria into the subarachnoid space and neurosurgical techniques (ventricular puncture, placement of reservoir placement of ventricular-peritoneal drainage, intracranial surgery, etc.) that favor the direct implant of bacteria in the central nervous system.

OPINION

On the subject of meningitis is a broad topic as it affects infants , children and adults what a vast subject , in this section I covered the topic of meningocele in neonates.

When reading about it , I could percatar neonatal meningitis in two types which are vertically and nosocomial . Which trigger other diseases in the neonate which result in more complications for the newborn.

BIBLIOGRAPHY

Meningitis neonatal

B. Fernández Colomer, J. López Sastre, G. D. Coto Cotallo,

A. Ramos Aparicio, A. Ibáñez Fernández.

Servicio de Neonatología

Hospital Universitario Central de Asturias. Oviedo

https://www.aeped.es/sites/default/files/documentos/22_0.pdf