Five-Year Multicenter Study of Clinical Tests of Neonatal Purulent Meningitis

Zhi, Zhao; Yu, Jialin; Zhang, Haibo; Li, Juhua; Li, Zhankui

doi:10.1177/0009922817728699

Cited by 12 publications

(13 citation statements)

References 28 publications

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“…The wide usage of broad-spectrum antibiotics has fueled the emergence of drug-resistant strains of E. coli, which poses a great challenge in the treatment of neonatal bacterial infections. Several recent studies have found that E. coli is widely resistant to ampicillin and shows different degrees of resistance to the thirdgeneration cephalosporins [2,7]. However, the drug resistance profile of E. coli shows considerable interregional variability depending on the local pattern of antibiotic use, which is worthy of further study.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and antimicrobial susceptibility of invasive Escherichia coli infection in neonates from 2012 to 2019 in Xiamen, China

et al. 2021

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Background Escherichia coli (E. coli) is one of the important causative pathogens of neonatal invasive infection. The epidemiological and clinical profile of invasive E. coli infection in Chinese newborns is not well characterized. Methods Ninety-four infants with invasive E. coli infection were categorized into E. coli early onset disease (EOD) group (onset ≤72 h after birth) (n = 46) and E. coli late onset disease (LOD) group (onset > 72 h) (n = 48). We compared and analyzed the clinical characteristics and drug sensitivity profile of early-onset and late-onset E. coli invasive infection in neonates. Results The incidence of E. coli-EOD and E.coli-LOD was 0.45/1000 live births (LBs) and 0.47/1000 LBs, respectively. The incidence of gestational diabetes mellitus, perinatal fever, urinary tract infection, chorioamnionitis, and positive E. coli culture among mothers in the E. coli-EOD group were significantly higher than that in E. coli-LOD group. The incidence of premature birth, low-birth-weight, nosocomial infection, and hospitalization time were significantly higher in the E. coli-LOD group. The main disease in E. coli-EOD group was pneumonia (main clinical manifestation: dyspnea). The main disease in E. coli-LOD group was sepsis (main clinical manifestation: fever). The sensitivity rates of E. coli strains to ampicillin and piperacillin were low (25.00–28.79%); sensitivity to cephalosporins was also low except ceftazidime (lowest sensitivity rate: 57.14%). Sensitivity to compound preparations containing β-lactamase inhibitors was high, even for extended spectrum β-lactamase-positive strains (nearly 100%). Conclusion E. coli is an important cause of invasive infection of newborns in Xiamen, China. E. coli-EOD was largely attributable to perinatal factors, while E. coli-LOD was largely related to nosocomial infection. Compound preparations containing β-lactamase inhibitor or carbapenem antibiotics should be preferred for neonatal invasive infection by E. coli.

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Section: Introductionmentioning

confidence: 99%

Epidemiology and antimicrobial susceptibility of invasive Escherichia coli infection in neonates from 2012 to 2019 in Xiamen, China

et al. 2021

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“…Forty-nine cases of children with purulent meningitis (mean ± SD: 15.5±17.0 months, range 2-89 months; 19 female) were collected from January 2016 to December 2018 in Beijing Children's Hospital of Capital Medical University. The criteria for a definite diagnosis of bacterial meningitis included [12,13] : (1) isolation of bacterial pathogens in one or more CSF cultures; (2) classic clinical manifestations including fever, headache, stiff neck, consciousness disturbance, and sign of meningeal irritation; (3) typical CSF findings including leukocyte counts > 0.1x109/L with predominant polymorphonuclear cells. All patients had been assessed by the Glasgow Outcome Scale GOS) ( Table 1), and rated as good prognosis if the GOS score was 5, and as poor prognosis if the GOS score was 1 to 4.…”

Section: Subjectsmentioning

confidence: 99%

The correlation between MRI findings and clinical prognosis in children with purulent meningitis

Kong

Guo

et al. 2019

Preprint

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Background: To explore the correlation between magnetic resonance imaging (MRI) findings and clinical prognosis in children with purulent meningitis. Methods : Forty-nine cases of children with purulent meningitiswere collected from January 2016 to December 2018 in Beijing Children's Hospital. According to the Glasgow Outcome Scale（GOS), there were 35 patients with good prognosis and 14 patients with poor prognosis. All patients were scanned by MRI. We used Chi-square test and Logistic regression to analyse the correlation between MRI features and clinical prognosis in children with purulent meningitis. Results : Among the two groups, the poor prognosis group had the worst imaging performance, while the good prognosis group had the lighter imaging performance. Chi-square test showed that the imaging signs of cerebral edema, cerebral hemorrhage, subdural effusion, hydrocephalus, venous sinus thrombosis, cerebral hernia had statistical significance between the two groups (P < 0.05). Multivariate logistic regression analysis showed that the signs of cerebral edema, subdural effusion were risk factor for poor prognosis (P < 0.001). Conclusion : There are many complications and sequelae in children with purulent meningitis. The MRI findings of cerebral edema, cerebral hemorrhage, subdural effusion, hydrocephalus, venous sinus thrombosis, cerebral hernia suggest poor prognosis. It is instructive to clinical treatment and prognosis.

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“… 13 A retrospective study conducted by Zhao et al showed that E. coli remains a prominent pathogen of NM. 14 Antibiotic treatment has always been a routine treatment for this infection. However, because of the emergence of drug-resistant bacteria, the curative effects of antibiotics have decreased.…”

Section: Introductionmentioning

confidence: 99%

Escherichia coli Causing Neonatal Meningitis During 2001–2020: A Study in Eastern China

Liu¹,

Zhu²,

Fu³

et al. 2021

IJGM

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Background and Objective Neonatal meningitis (NM) caused by Escherichia coli remains a major health problem in industrialized countries. Currently, information on the epidemiology and antimicrobial susceptibility patterns of NM in developing countries such as China is relatively scarce. Therefore, the present study investigated changes in the antimicrobial susceptibility of E. coli causing NM in a perinatal center in eastern China over the past 20 years. Methods This survey was conducted during three periods: 2001–2006, 2007–2012, and 2013–2020. NM was diagnosed according to the number of white blood cells in the cerebrospinal fluid (CSF) and the presence of a single potential pathogenic bacterium in the culture prepared from the blood or CSF of a newborn baby. Changes in the antimicrobial susceptibility of E. coli were analyzed. Results In total, 182 NM cases were identified. E. coli was identified in 69 of these cases, and in 21 of these cases, extended-spectrum beta-lactamase (ESBL) production was detected. E. coli was the main cause of NM identified in this study. The overall susceptibility of E. coli to third-generation cephalosporins such as cefotaxime decreased from 100% during 2001–2006 to 50% during 2007–2012 and, subsequently, increased to 71.0% during 2013–2020. This pattern of change is correlated with bacterial ESBL production. Only 8.3% of E. coli found in samples collected from infants with early onset meningitis (EOM) produced ESBL, while 37.3% of E. coli isolated from children with late-onset meningitis (LOM) produced ESBL. Conclusion E. coli remains the primary pathogen of NM. Compared with that isolated from infants with LOM, the percentage of ESBL-producing multidrug-resistant E. coli isolated from infants with EOM is significantly lower. Clinicians should consider this trend when determining appropriate and effective antibiotics as empirical treatment for NM.

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Five-Year Multicenter Study of Clinical Tests of Neonatal Purulent Meningitis

Cited by 12 publications

References 28 publications

Epidemiology and antimicrobial susceptibility of invasive Escherichia coli infection in neonates from 2012 to 2019 in Xiamen, China

Epidemiology and antimicrobial susceptibility of invasive Escherichia coli infection in neonates from 2012 to 2019 in Xiamen, China

The correlation between MRI findings and clinical prognosis in children with purulent meningitis

Escherichia coli Causing Neonatal Meningitis During 2001–2020: A Study in Eastern China

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