Application of the Bacterial Meningitis Score for Infants Aged 0 to 60 Days

Chris A Rees; Andrea T Cruz; Stephen B Freedman; Prashant Mahajan; Neil G Uspal; Pamela Okada; Paul L Aronson; Amy D Thompson; Paul T Ishimine; Suzanne M Schmidt; Nathan Kuppermann; Lise E Nigrovic; HSV Study Group of the Pediatric Emergency Medicine Collaborative Research Committee

doi:10.1093/jpids/piy126

Application of the Bacterial Meningitis Score for Infants Aged 0 to 60 Days

J Pediatric Infect Dis Soc. 2019 Dec 27;8(6):559-562. doi: 10.1093/jpids/piy126.

Affiliations

¹ Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Massachusetts.
² Department of Pediatrics, Sections of Emergency Medicine and Infectious Diseases, Baylor College of Medicine, Houston, Texas.
³ Department of Pediatrics, Sections of Pediatric Emergency Medicine and Gastroenterology, Alberta Children's Hospital and Cumming School of Medicine, University of Calgary, Canada.
⁴ Departments of Emergency Medicine and Pediatrics, Mott Children's Hospital, University of Michigan, Ann Arbor.
⁵ Division of Pediatric Emergency Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Dallas.
⁶ Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Texas Southwestern Medical Center, Dallas.
⁷ Departments of Pediatrics and Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
⁸ Departments of Pediatrics and Emergency Medicine, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware.
⁹ Departments of Emergency Medicine and Pediatrics, Rady Children's Hospital, University of California, San Diego School of Medicine, IL.
¹⁰ Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, IL.
¹¹ University of California Davis Health and the University of California Davis School of Medicine, Sacramento.

PMID: 30535235
DOI: 10.1093/jpids/piy126

Abstract

In 4292 infants aged ≤60 days with cerebrospinal fluid (CSF) pleocytosis, the bacterial meningitis score had excellent sensitivity (121 of 121 [100.0%] [95% confidence interval, 96.5%-100.0%]) but low specificity (66 of 4171 [1.6%] [95% confidence interval, 1.3%-2.0%]) and therefore should not be applied clinically to infants in this age group.

Keywords: bacterial meningitis score; infants; sensitivity; specificity.

© The Author(s) 2018. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Publication types

Multicenter Study

MeSH terms

Bacteria / classification*
Bacteria / isolation & purification
Female
Humans
Infant
Infant, Newborn
Leukocytosis / cerebrospinal fluid
Leukocytosis / diagnosis
Leukocytosis / epidemiology
Leukocytosis / microbiology
Male
Meningitis, Bacterial / cerebrospinal fluid
Meningitis, Bacterial / diagnosis*
Meningitis, Bacterial / epidemiology*
Meningitis, Bacterial / microbiology*
Retrospective Studies
Sensitivity and Specificity