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Pediatr Infect Dis J. 2011 Mar;30(3):212-7.

Neonatal Bacterial Meningitis: 444 Cases in 7 Years.

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1
Service de Pédiatrie et Réanimation Néonatales, Hôpital Antoine-Béclère, Université Paris-Sud, Clamart, France.

Abstract

BACKGROUND:

Neonatal bacterial meningitis remains a severe infectious disease with mortality rates varying between 10% and 15%. The clinical and bacteriologic features of neonatal meningitis collected from January 2001 to December 2007 in a French national survey are presented here.

METHODS:

Cases of neonatal meningitis were prospectively collected by a network of 252 pediatric wards covering 61% of French pediatric wards, associated with 168 microbiology laboratories. Neonatal meningitis was classified as early-onset (d0-d4) and late-onset (d5-d28). Statistical analyses were performed according to gestational age and weight at birth.

RESULTS:

A total of 444 cases of neonatal bacterial meningitis were reported by 114 pediatric wards. Five cases were excluded from analysis. Group B streptococci (GBS) and Escherichia coli accounted respectively for 59% and 28% of the cases, followed by Gram-negative bacilli other than E. coli (4%), other streptococci (4%), Neisseria meningitidis (3%), and Listeria monocytogenes (1.5%). GBS was the most common pathogen both in early-onset (77% vs. 18% for E. coli) and in late-onset meningitis (50% vs. 33% for E. coli). Among preterm infants, E. coli was more commonly isolated (45% vs. 32% for GBS), especially in very preterm infants (54%). GBS was more often involved in seizures than E. coli (41% vs. 25%). The overall mortality rate was 13% but reached 25% in preterm or small for gestational age infants, regardless of the etiology.

CONCLUSIONS:

GBS was the dominant cause of neonatal bacterial meningitis, with 77% of early-onset and 50% of late-onset cases. E. coli was the most common bacteria in preterm infants.

PMID:
21416693
DOI:
10.1097/inf.0b013e3181fab1e7
[Indexed for MEDLINE]

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