A 20-day-old term neonate presents with poor feeding, lethargy, and a bulging anterior fontanelle. CSF examination confirms bacterial meningitis. The two most common causative organisms of bacterial meningitis in this age group are:

• A Haemophilus influenzae type b and Streptococcus pneumoniae
• B Streptococcus agalactiae and Escherichia coli ✓
• C Neisseria meningitidis and Listeria monocytogenes
• D Staphylococcus aureus and Klebsiella pneumoniae

Explanation

In the neonatal period, group A Streptococcus (Streptococcus agalactiae, acquired from maternal genital tract colonization) and Escherichia coli account for the large majority of bacterial meningitis cases. Haemophilus influenzae type b, pneumococcus, and meningococcus become important only after the first few weeks to months of life, once passively transferred maternal antibody wanes. Empiric neonatal therapy is accordingly ampicillin plus an aminoglycoside or third-generation cephalosporin.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.