title: Neonatal bacterial meningitis: Results from a cross-sectional hospital based study.
abstract: OBJECTIVE
  The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates born in the Department of Gynaecology and Obstetrics, University Clinical Centre Tuzla, Bosnia and Herzegovina, admitted to Intensive care unit (NICU) or readmitted, because of suspected infection, after discharge from the nursery.
  
  
  METHODS
  This study was carried out from July 1, 2012 to June 30, 2013. During this period 4136 neonates were born. All neonates admitted to the Intensive care unit with signs and symptoms of systemic infections, and neonates readmitted to the Intensive care unit, after discharge from the nursery for sepsis work up were included in the study.
  
  
  RESULTS
  Eighteen of 200 neonates (9%) admitted or readmitted to the NICU developed meningitis. 61% cases were late onset meningitis. The overall incidence was 4.4/1000 live births. The mortality rate was 11.1%. The mean age of symptom presentation was 8.7 days. The most common clinical features were: fever, respiratory distress and jaundice. Significant risk factors for acquiring meningitis were: male gender, Caesarean delivery, stained amniotic fluid. Positive CSF finding were detected in 6/18 (33.3%) of cases. Gram-positive bacteria were more frequently responsible for confirmed meningitis. In all neonates with meningitis blood culture was examined and 5 (50%) yielded Gram-negative bacteria.
  
  
  CONCLUSIONS
  The high rates of neonatal meningitis with predominant late onset may suggest nosocomial origin. Measures to improve antenatal, intrapartum and delivery care and measures during NICU hospitalisation are necessary to lower the risk of nosocomial infections.
authors.affiliation: Department of Paediatrics University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina. izeta.softic@bih.net.ba.
authors.forename: Izeta
authors.initials: I
authors.lastname: Softić
authors.affiliation: Department of Medical Sciences, Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.
authors.forename: Husref
authors.initials: H
authors.lastname: Tahirović
authors.affiliation: Department of Paediatrics University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.
authors.forename: Mensuda
authors.initials: M
authors.lastname: Hasanhodžić
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology; D000653:Amniotic Fluid; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004756:Enterobacteriaceae Infections / Q000453:epidemiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology*; D008584:Meningitis, Listeria / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D012737:Sex Factors; D013203:Staphylococcal Infections / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology