The characteristics and therapeutic management of nosocomial neonatal meningitis in Serratia Marcescens in a Moroccan neonatal unit

Introduction : Meningitis in Serratia marcescens (S. marcescens) are rare but potentially serious, especially in newborns. They require rapid identification, adequate management combined with rigorous aseptic rules. Objective: Report the experience of our department in the management of neonatal meningitis due to S. marcescens. Material and methods: Retrospective study of 4 cases of neonatal nosocomial meningitis due to S. marcescens hospitalized in the neonatal intensive care unit at Marrakech University Hospital during an epidemic between January and March 2023. Results :Of 32 patients who developed a nosocomial S infection. marcescens12.5% presented meningitis with the same organism. The average term was 35.2 weeks of amenorrhea. The average age of admission was 2.6 days. The average time between hospitalization and development of meningitis was 4.5 days. Clinically: 3 patients presented a fever, 2 developed hypotonia with refusal to breastfeed and one presented generalized convulsions, a bulging fontanelle with an increase in head circumference. Pleocytosis, hyperproteinorachia and hypoglycorachia were constant in all our patients. We noted resistance to all antibiotics in all cases. All of our patients had at least onepositive blood culture S. marcescens. Transfontanellar ultrasound revealed ventriculitis in a newborn. All of our patients benefited from geographic isolation and were treated with Meropenem and Amikacin. The evolution was favorable in 3 newborns and we noted the death of only one case (low weight). Conclusion: Early identification of patients with this type of meningitis and rapid implementation of control measures are essential to curb the spread of this severe infection.