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907 7 |
Ultima descărcare din IBN: 2024-05-12 22:02 |
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616.831.9-002-022.7-053.31 (1) |
Neurologie. Neuropatologie. Sistem nervos (974) |
SM ISO690:2012 ROTARU, Dorina, BRAILA, Elena, PÎNZARI, Ludmila, ANTOCI, Victoria, BALEANU, Galina, CONDORACHI, Aliona, BALEA, Zinaida, CARAMAN, Anatolie. Particularităţile evoluţiei clinice şi paraclinice a meningitei neonatale de origine bacteriană. In: Buletin de Perinatologie, 2016, nr. 2(70), pp. 48-58. ISSN 1810-5289. |
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Buletin de Perinatologie | |||||||
Numărul 2(70) / 2016 / ISSN 1810-5289 | |||||||
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CZU: 616.831.9-002-022.7-053.31 | |||||||
Pag. 48-58 | |||||||
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Background. Neonatal meningitis is the inflammation of meninges which usually occurs in the first 30 days of life. However, in neonatal intensive care units and increased availability of antibacterial drugs and supportive care, neonatal meningitis is still a serious disease with high morbidity and mortality rates. Objective: determine the structure of causative pathogens of meningitis in neonates. Goal: determination of the incidence, of clinical and laboratory evolution of neonates meningitis with determination of the causative pathogens structure and susceptibility to the antibiotic. Materials and methods: the study case has been done on 72 children with IMSP IMC with suspects of diagnostic on neonatal meningitis, being divided in two groups: 1st group - 22 children with confirmed diagnosis of meningitis, confirmed by LP and 2d group- 51 children with suspects of meningitis, the diagnosis of meningitis was ruled out based on the results LP. Obtained results: In group I and group II children and determined statistical differences in mean birth weight category 1675,45 g ( /-609,187) vs 1808,08 g. ( /-779,048) (p=0,382), the average gestation period (31,68 gestational age ( /-3,61) vs 32,73 gestational age ( /-4,73) (p=0,43) and the day of onset of clinical signs 16,91( /-13,51) vs 16,16( /-11,82) ( p=0,812). Clinical signs that was prevailing was 72,7% of respiratory insufficiency, 54,5% of seizures, 50% of fever, 27,3% fontanelle bulging (p<0,05).. Following the laboratory investigations was determined a tendency to leukocytosis , the average rate of leukocytes being 19,395x109( /- 12,603SD) (p<0.05) and the hypothermia determined in 31,8% of cases (p<0.00). In 25% cases it was found the same pathogen in blood culture and CSF. Conclusion: Neonatal bacterial meningitis is a common pathology premature babies in particular ELBW, as clinical and laboratory signs are common to other diseases in the neonatal period. LP remains the gold standard for the diagnosis and treatment of bacterial meningitis. The causative agents of neonatal meningitis were gram negative bacteria that showed a higher sensibility than ahminoglycosides, carbapenems and fluoroquinolones, which allows their empirical therapy use. |
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