Prevalence of Meningitis Among Neonates With Sepsis: Analysis of Predictors at a Tertiary Care Hospital in Bangladesh

Objective To identify the prevalence of neonatal meningitis and to describe the clinical, haematological and bacteriological profiles of neonatal sepsis and meningitis. This study also aimed to identify the factors predictive of meningitis among neonates with sepsis. Methods A hospital‐based, cross‐sectional study was carried out among neonates admitted with clinical sepsis from May 2021 to August 2021 in the neonatal unit of Chittagong Medical College Hospital (CMCH). All enrolled patients underwent blood culture, sepsis screening, CSF analysis and culture. Data were analyzed using SPSS version 27.0. Multivariate logistic regression analysis was used to identify risk factors, and a p value of < 0.05 was considered statistically significant. Results A total of 113 neonates were enrolled in this study. Most cases were male (70.8%), term (81.4%), low birth weight (51.3%) and late‐onset sepsis (70%). Meningitis was detected in 39 (34.5%) neonates, with a prevalence of 29.4% in early‐onset sepsis and 36.7% in late‐onset sepsis. Blood cultures were positive in 37% cases, while CSF culture was positive in only 3.5%. Staphylococcus aureus was the most common isolate, showing high resistance to first‐ and second‐line antibiotics. Previous hospitalization (aOR: 6.4; 95% CI: 2.34–17.65), bulged fontanelle (aOR: 3.7; 95% CI: 1.09–12.56) and leukopenia/leukocytosis (aOR: 5.03; 95% CI: 1.66–15.29) were identified as important predictors of neonatal meningitis. Conclusion One‐third of neonates with sepsis had concurrent meningitis in our study. Blood cultures were negative in more than half of the patients with meningitis. Routine CSF analysis is essential in all septic neonates, specifically with a history of previous hospitalization, bulged fontanelle and leukopenia/leukocytosis.