348. Streptococcus agalactiae, Streptococcus pneumoniae, Neisseria meningitidis and Enterobacateriaceae as Leading Causes of Bacterial Meningitis in Infants Younger than Three Months Old in a Mexican Hospital: Six Years of Active Surveillance.
Session: Poster Abstract Session: CNS Infections
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • IDSA 2018.jpg (3.0 MB)
  • Background: In Mexico, several publications have mentioned that Enterobacteriaceae are the main causes of bacterial meningitis (BM) in young infants (< 3 months), with S. agalactiae (GBS) and other bacteriae present in a much lesser extent, however, these studies have been performed mostly at Mexico-City, and little is known on the northwest Mexico/US Border, particularly at Tijuana, Mexico (the highest transited frontier in the planet).

    Methods: Since January/1st/2012 until December/31st/2017 (six years) we underwent active/prospective surveillance to identify all causes of non-nosocomial-acquired BM in infants < 3 months old at the Tijuana General Hospital, Mexico. Bacterial identification was performed either by cultures or PCR, pneumococcal serotyping by the Quellung Reaction (Statens Serum Institute ®) or PCR, and meningococcal serogrouping using the Pastorex-Agglutination Meningitis kit (Alere, Ltd ®)., Demographic, clinical, laboratorial and microbiological data were saved, and statistical analysis was merely descriptive.

    Results: In six years, twenty BM cases (3.33 per year) were identified, among which sixteen (80%) were newborns < 1 month old. GBS was the leading cause (7=35%), followed by S. pneumoniae (4=20%, serotypes 19A, 33C, 18B and 12), N. meningitidis (3=15%, serogroups C, Y and B), Enterobacteriaceae (3=15%, E. coli, E. clocae, P..mirabilis), N. gonorrheae (2=10%) and L. monocytogenes (1=5%), see Fig-1. Overall lethality was of 5 (25%). Highest mortality was found in newborns < 7 days old (66.6%), and BM caused by Enterobacteriaceae (66.6%). Among survivors, 7 (35%) developed sequelae three months following discharge.

    Conclusion: Etiology of BM in young infants in Tijuana differs from Mexico-City, with GBS, S. pneumoniae, N. meningitidis as leading causes, along with Enterobacteriaceae. BM in young infants is associated with high mortality and morbidity, especially in newborns and those caused by Enterobacteriaceae. Preventive measures, such as mother screening for GBS carriage/penicillin prophylaxis, as well as early vaccination vs S. pneumoniae and N. meningitidis should be considered based on further results obtained from this active surveillance in the future.

    Enrique Chacon-Cruz, MD1, Erika Zoe Lopatynsky-Reyes, MD2, Lucila Alejandra Almada-Salazar, MD3, Rosa Maria Rivas-Landeros, PhD4, Maria Luisa Volker-Soberanes, PhD4 and Jorge Arturo Alvelais-Palacios, MD, PhD3, (1)Pediatrics, Hospital General de Tijuana, Tijuana, Baja-California, Mexico, (2)School of Public Health, University of California-San Diego, San Diego, CA, (3)School of Medicine, Universidad Autonoma de Baja California, ECISALUD, Tijuana, Mexico, (4)Microbiology, Hospital General de Tijuana, Tijuana, Baja-California, Mexico

    Disclosures:

    E. Chacon-Cruz, None

    E. Z. Lopatynsky-Reyes, None

    L. A. Almada-Salazar, None

    R. M. Rivas-Landeros, None

    M. L. Volker-Soberanes, None

    J. A. Alvelais-Palacios, None

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