Objective To compare the demographical, clinical and laboratory features, and outcomes of neonates with enteroviral meningitis (EVM) with those with bacterial meningitis (BM).

Methods A retrospective two-center study was performed in La Réunion Island between January 2008 and December 2018 in hospitalized neonates aged less than 29 days. Patients positive for enterovirus real-time polymerase chain reaction from the cerebrospinal fluid (CSF) were diagnosed with EVM. Neonates with positive CSF culture results for a potentially pathogenic bacterium were diagnosed with BM.

Results Compared with their EVM peers (n = 20), BM-infected neonates (n = 14) had lower birth weight, and were more likely to present hypotension and neurological symptoms on admission. Thrombocytopenia, elevated serum procalcitonin, hyperproteinorachia, hypoglycorrhachia, CSF pleocytosis, a bacterial meningitis score >0 were more frequent in the BM-infected group. All BM-infected neonates had at least one abnormal cutoff value in the CSF, while nine neonates (45%) in the EVM group had no CSF abnormality (p = 0.004). BM-infected neonates also had a longer length of hospital stay, needed more supportive care, received more prolonged antimicrobial courses, and developed respiratory and neurological complications.

Conclusion Recognition of some clinical and laboratory features can help clinicians in differentiating BM from EVM when managing this high-risk patient group.

目的 比较新生儿肠病毒性脑膜炎（EVM）和细菌性脑膜炎（BM）的人口统计学，临床和实验室特征以及结局。

方法 于2008年1月至2018年12月在留尼汪岛（LaRéunionIsland）对住院时间小于29天的新生儿进行两中心回顾性研究。从脑脊液（CSF）获得肠病毒实时聚合酶链反应阳性的患者被诊断为EVM。CSF培养阳性的潜在致病细菌新生儿被诊断为BM。

结果 与他们的EVM同龄人（n  = 20）相比，受BM感染的新生儿（n  = 14）的出生体重较低，入院时更容易出现低血压和神经系统症状。在BM感染组中，血小板减少症，血清降钙素原升高，蛋白尿过少，糖尿不足，CSF胞浆增多，细菌性脑膜炎评分> 0更为常见。所有BM感染的新生儿的CSF中至少有一个异常截止值，而EVM组中的9个新生儿（45％）没有CSF异常（p  = 0.004）。受BM感染的新生儿住院时间也更长，需要更多的支持治疗，接受了更长的抗菌疗程，并且出现了呼吸系统和神经系统并发症。

结论 对一些临床和实验室特征的认识可以帮助临床医生在管理这一高风险患者群时将BM与EVM相区别。