Clinical, Laboratory Characteristics, and Microorganism Infection Status in Neonates With Meningitis in Vietnam: A Cross-Sectional Descriptive Study.

Abstract

Objective: This study is aimed at describing the clinical and laboratory characteristics and determining the prevalence of microbial pathogens causing neonatal meningitis detected by cerebrospinal fluid (CSF) real-time polymerase chain reaction (PCR).

Materials and methods: A cross-sectional descriptive study was conducted on 55 neonates diagnosed with meningitis. Pathogens were identified by using CSF real-time PCR, CSF culture, or blood culture.

Results: Late-onset meningitis accounted for 85.5% (47/55) of cases. The most common clinical signs were respiratory distress (56.4%), fever (47.3%), and lethargy (34.5%). The median white blood cell count was 13,560/mm³ (8645-20,709/mm³), and the median absolute neutrophil count was 6063/mm³ (2895-12,508/mm³). C-reactive protein levels were higher in full-term neonates (8.55 mg/L) compared to preterm neonates (6.4 mg/L). The median CSF protein level was 1.4 g/L (1.1-1.73 g/L), with preterm neonates having significantly higher levels (1.59 vs. 1.22 g/L; p = 0.013). Blood cultures identified seven cases. Real-time PCR detected pathogens in only three cases (5.5%). No demographic or clinical factors were found to significantly differ between the groups with and without identified microbial pathogens (p > 0.05).

Conclusion: Neonatal meningitis commonly manifests with respiratory distress, fever, and lethargy. While real-time PCR enables the detection of viral and rare pathogens, its limited overall detection rate underscores the importance of early diagnosis based on clinical presentation and CSF analysis rather than exclusive reliance on microbiological evidence, which may delay essential treatment.