Abstract：Objective To analyze the clinical characteristics and risk factors of neonatal refractory purulent meningitis. Methods The clinical data of 141 children with purulent meningitis who were admitted to the Department of Neonatology, Kunming Children’s Hospital from January to December 2017 were retrospectively analyzed. According to the bacterial culture results, they were divided into common group (99 cases) and refractory group (42 cases). General data, clinical manifestations, and laboratory test results of two groups were compared. The risk factors of refractory purulent meningitis in neonates were analyzed by logistic regression. Results There were no significant differences in the proportion of male infants, premature infant, birth weight < 2 500 g, amniotic fluid contamination, early-onset meningitis, and anti-infective treatment before admission between two groups (P > 0.05). There was no significant difference in the proportion of fever, convulsion, respiratory symptoms, and digestive tract symptoms between two groups (P > 0.05). The proportion of elevated blood plasma procalcitonin (PCT), positive bacteria culture was higher in refractory group than those in normal group, the white blood cell count and protein content of cerebrospinal fluid (CSF) were higher than those in normal group, and the glucose content of CSF was lower than that in normal group (P < 0.05); there was no significant difference in the proportion of abnormal peripheral blood white blood cell count and elevated blood C-reactive protein between two groups (P > 0.05). There was no significant difference in the distribution of pathogenic bacteria between two groups (P > 0.05). The total incidence of neurological symptoms between two groups was statistically significant (P < 0.05). The fever-reducing time and hospitalization time in refractory group were longer than those in normal group (P < 0.05); there was no significant difference in clinical outcome between two groups (P > 0.05). High CSF protein content, combined with neurological symptoms were independent risk factors for refractory neonatal purulent meningitis (OR > 1, P < 0.05), and high CSF glucose content was a protective factor for refractory neonatal purulent meningitis (OR < 1, P < 0.05). Conclusion The clinical manifestations of neonatal refractory purulent meningitis are not typical. The blood and CSF infection markers of the children are significantly abnormal, and neurological symptoms are prominent. Therefore, it is difficult to treat such children. High blood PCT and CSF protein content, and combined with neurological symptoms are independent risk factors for neonatal refractory purulent meningitis, and high CSF glucose content is a protective factor.
何疏梅 赵晓芬 和灿林 朱双燕 熊飞 樊茂 马丽莎 李杨方▲. 新生儿难治性化脓性脑膜炎临床特点及高危因素分析[J]. 中国医药导报, 2022, 19(24): 93-97.
HE Shumei ZHAO Xiaofen HE Canlin ZHU Shuangyan XIONG Fei FAN Mao MA Lisha LI Yangfang▲. Analysis of clinical characteristics and high risk factors of neonatal refractory purulent meningitis #br#. 中国医药导报, 2022, 19(24): 93-97.
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