Analysis Of Clinical Data And Adverse Prognosis Risk Factors Of Neonatal Suppurative Meningitis In A Single Center

Objective: The clinical characteristics of neonatal bacterial meningitis and the risk factors for poor prognosis of neonatal septic meningitis were analyzed for better clinical guidance.Methods: In this study,children who were diagnosed with neonatal suppurative meningitis during January 1,2011-December 31,2021 in the Obstetrics Department of the Affiliated Hospital of Yan’an University and transferred to the Department of Neonatology were selected as the research objects.The clinical data of the infants and their mothers were retrospectively analyzed.The children were divided into good prognosis group and poor prognosis group according to their clinical outcomes at discharge,and the clinical data of the two groups of children and pregnant mothers were analyzed by univariate analysis;the items with statistical significance in the results of univariate analysis were analyzed in multiple ways.Factor Logistic regression analysis.Outcome: 1.Clinical data: In this study,based on the clinical data of 76 pregnant women with children,it was found that children whose mothers had no fixed occupation,suffered from various infections during pregnancy,and had normal delivery were more likely to develop purulent meningitis;for the general data analysis of the children,It was found that full-term males,normal births,and children with abnormal amniotic fluid were more likely to develop suppurative meningitis;clinical manifestations were fever,shortness of breath,jaundice,and poor response,and laboratory tests showed higher infection indicators,with elevated CRP and PCT as the main symptoms.Mainly;the positive rate of pathogenic bacteria culture was 27.6%,and Staphylococcus epidermidis and Escherichia coli infections were more common;in terms of antibiotic use,it was found that the use of penicillin combined with ceftriaxone and penicillin combined with meropenem was relatively high.2.Univariate analysis: In the general information of pregnant mothers,there were no significant differences in factors such as mother’s age,mother’s occupation,mode of delivery,primipara,adverse pregnancy history,and pregnancy diseases(P>0.05);In the general information,only the low body weight and length of hospital stay between the two groups had statistically significant differences(P<0.05),but gender,gestational age,body length,head circumference,chest circumference,abnormal umbilical cord,abnormal amniotic fluid and other factors were not significant.Statistically significant(P>0.05).In the clinical manifestations of the two groups,whether it was fever,convulsions,abnormal muscle tone,irritability,or clinical manifestations such as cough,cyanosis,hypothermia,and yellow staining in children,there was no significant statistical significance(P<0.05).The results of laboratory tests showed that there were statistically significant differences in abnormal white blood cells,abnormal electrolytes,total protein in cerebrospinal fluid,and glucose in cerebrospinal fluid(P<0.05).In terms of pathogenic bacteria,Escherichia coli was significantly different(P<0.05);in terms of antibiotic use,there was no significant difference between the two groups(P>0.05).3.Cerebrospinal fluid total protein level >2 g/L and CSF glucose level <1.8 mmol/L are independent risk factors for poor prognosis of NPM.4.ROC curve analysis showed that the sensitivity of cerebrospinal fluid protein>2g/L to predict the poor prognosis of neonatal suppurative meningitis was 0.853,the specificity was 0.881,and the area under the curve was 0.905.The sensitivity of cerebrospinal fluid glucose <1.8mmol/L to predict the poor prognosis of neonatal suppurative meningitis was0.786,the specificity was 0.882,and the area under the curve was 0.854.The sensitivity of the combination of the two to predict the poor prognosis of the disease was 0.853,the specificity was 0.905,and the area under the curve was 0.905.Conclusion: 1.Neonatal suppurative meningitis occurs mostly in full-term males.The clinical manifestations are fever,shortness of breath,jaundice,and poor reaction.The laboratory examination infection indicators are relatively high,mainly CRP and PCT.Followed by coagulase-negative staphylococcus,Escherichia coli,hemolytic staphylococcus.2.Prolonged hospital stay,low birth weight,abnormal white blood cells,abnormal electrolytes,elevated cerebrospinal fluid protein,low cerebrospinal fluid glucose,and Escherichia coli infection were risk factors for poor prognosis of purulent meningitis.Multivariate analysis found that cerebrospinal fluid protein>2g/L and cerebrospinal fluid glucose<1.8 mmol/L were independent risk factors for poor prognosis in cerebral palsy.3.Cerebrospinal fluid protein > 2 g/L and cerebrospinal fluid glucose < 1.8 mmol/L have a certain predictive value for the poor prognosis of the disease,and the combination of the two has a higher clinical value in evaluating the prognosis of the disease.