Cerebrospinal fluid values in the very low birth weight infant

Rodriguez, Adib; Kaplan, Sheldon L.; Mason, Edward O.

doi:10.1016/s0022-3476(05)80663-8

Cited by 55 publications

(30 citation statements)

References 6 publications

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“…Although the 'classical picture' of the CSF in neonatal meningitis shows an increased number of white cells, predominantly polymorphonuclear, increased protein and decreased glucose compaired with blood glucose (!0.5), the interpretation of CSF findings can pose problems. A most important factor for this relates to the uncertainty of normal CSF values which have a wide range regarding the number of cells, protein and glucose leading to a significant overlap between neonates without or with meningitis [32,33]. In the study by Sarff et al [32], only 0.84% (1/119) of the neonates with meningitis had normal values on initial LP for all three parameters of the CSF.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

et al. 2000

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The aim of this retrospective study was to evaluate the clinical efficacy in terms of mortality and long-term morbidity of third generation cephalosporins and amikacin in combination for the treatment of gram-negative bacterial meningitis in a homogeneous group of neonates. A 15-year experience (1983–1997) with 72 term neonates without central nervous system anomalies and with gram-negative organisms grown in their cerebrospinal fluid treated with the above combination of antibiotics is presented. All isolated organisms were sensitive to cefotaxime or ceftazidime and to amikacin but 80% were resistant to ampicillin. The predominant infecting organism was Escherichia coli (68.0%) which was sensitive to both cefotaxime and amikacin in all cases but resistant to ampicillin in 48% of cases. Survival at discharge was 97.2% but ultimate survival was reduced to 94.4%, as 2 patients died a few months following discharge of conditions unrelated to meningitis. Ventriculitis was diagnosed in 10 neonates (13.8%). Among survivors, 1 neonate (1.3%) developed hydrocephalus needing shunting and 1 neonate (1.3%) with Proteus mirabilis developed a brain abscess with relapse of meningitis which was successfully treated with a 6-week course of chloramphenicol. At follow-up at an age greater than 6 months, 91.1% of the surviving infants were normal, while 92.3% of survivors at an age greater than 6 years were normal and attended normal school. These results, despite any reservations due to the nature of the study (retrospective, uncontrolled study), strongly support the use of third generation cephalosporins and amikacin in combination for the treatment of neonatal gram-negative bacterial meningitis.

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Section: Discussionmentioning

confidence: 99%

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

et al. 2000

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“…The hypothesis that there might be clinical and/or laboratory findings that could differentiate between meningitis infections due to Gram-negative and Gram-positive agents, along with the scarcity of data on this disease in Brazilian publications, was the motivation for conducting this study. Given the controversy regarding clinical and laboratory meningitis confirmations 1,10,11 , it was decided to use a gold-standard-based diagnosis, i.e. positive CSF culture.…”

Section: Discussionmentioning

confidence: 99%

Neonatal meningitis according to the microbiological diagnosis: a decade of experience in a tertiary center

Bentlin¹,

Ferreira²,

Rugolo³

et al. 2010

Arq. Neuro-Psiquiatr.

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The aim of this study was to evaluate the incidence of and mortality due to meningitis and compare data according to microbiological diagnosis. This was a ten-year retrospective study conducted at a neonatal intensive care unit (NICU). Newborns with meningitis confirmed by positive CSF culture were included; those with congenital infection or malformations that made lumbar puncture impossible were excluded. The variables investigated were birth weight, gestational and postnatal age, procedures, hematological and CSF parameters, and complications. Parametric and non-parametric tests were used (statistical value p<0.05). The incidence of meningitis was 0.6% and mortality was 27%. Of the 22 cases, 59% involved Gram-negative bacteria; 36% Gram-positive and 5% fungi. The groups did not differ in relation to birth weight, gestational and postnatal age, procedures or hematological and CSF parameters. Sepsis, convulsions and deaths were frequent in both groups, without statistical difference. Gram-negative cases showed abscesses and higher frequency of ventriculitis and hydrocephaly. Meningitis was infrequent, but presented high mortality and frequent complications. Key words: meningitis, newborn, central nervous system, sepsis.Meningite neonatal de acordo com diagnóstico microbiológico: uma década de experiência em centro terciário RESUMO O objetivo do estudo foi avaliar incidência e mortalidade da meningite e comparar dados de acordo com o diagnóstico microbiológico. Estudo retrospectivo, de 10 anos, em UTI Neonatal. Incluídos RNs com meningite confirmada por cultura de líquor positiva; RN com infecção congênita ou malformações que impedem punção lombar foram excluídos. Variáveis: peso ao nascimento, idades gestacional e pós natal, procedimentos, parâmetros hematológicos e liquóricos, complicações. Testes paramétricos e não paramétricos foram utilizados (valor estatístico p<0,05). A incidência de meningite foi de 0,6% e mortalidade de 27%. Dos 22 casos, 59% foram por bactérias Gram-negativas; 36% por bactérias Grampositivas e 5% por fungos. Grupos não diferiram quanto ao peso ao nascimento, idades gestacional e pós-natal, procedimentos e por parâmetros hematológicos e liquóricos. Sepse, convulsões e óbitos foram frequentes e não diferiram entre os grupos. Gramnegativos causaram abscessos e mais frequentemente ventriculite e hidrocefalia. Meningite não foi freqüente, mas apresentou alta mortalidade e complicações. Palavras-chave: meningite, recém-nascido, sistema nervoso central, sepse.

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“…The first is that VLBW babies have naturally higher concentrations of protein than more mature infants, see Appendix 2. 98 The other complication is intraventricular haemorrhage which may occur in 15070 of babies." Blood staining obviously invalidates the protein measurement because of the much higher concentrations of plasma proteins.…”

Section: Infectionmentioning

confidence: 99%

Role of the Clinical Biochemistry Laboratory in the Management of Very Low Birthweight infants

Henderson

Dear

1993

Ann Clin Biochem

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Cerebrospinal fluid values in the very low birth weight infant

Cited by 55 publications

References 6 publications

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

Neonatal meningitis according to the microbiological diagnosis: a decade of experience in a tertiary center

Role of the Clinical Biochemistry Laboratory in the Management of Very Low Birthweight infants

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