Guidelines for the management of suspected and confirmed bacterial meningitis in Canadian children older than one month of age

Saux, Nicole Le

doi:10.1093/pch/19.3.141

Cited by 29 publications

(16 citation statements)

References 35 publications

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“…Such a strategy would bring the UK in line with recommendations from other developed countries, for example Canada,9 the USA10 11 and Netherlands 12. In these countries the empirical antibiotic recommendation for meningitis is to use a penicillin in addition to cefotaxime in the 1st month of life, but not beyond this age.…”

Section: Rational Antibiotic Prescribingmentioning

confidence: 99%

Empirical antibiotic cover for Listeria monocytogenes infection beyond the neonatal period: a time for change?

et al. 2015

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Listeria monocytogenes is a Gram-positive bacterium which can cause invasive infection in the immunocompromised, pregnant women and young infants. Listeria are not susceptible to the third generation cephalosporins (such as cefotaxime or ceftriaxone) usually given as empirical antibiotic treatment to unwell children. Amoxicillin or ampicillin is thus added for infants less than 3 months of age with suspected serious bacterial infection. However empirical antibiotic cover for L. monocytogenes infection beyond the neonatal period may not be needed. CURRENT RECOMMENDATIONThe National Institute of Health and Care Excellence (NICE) clinical guidelines on 'Feverish illness in children' (2007) 1 and 'Bacterial meningitis and meningococcal septicaemia' (2010) 2 recommend that the empirical antibiotic cover for infants 0-3 months of age admitted from home with suspected serious bacterial infection should be amoxicillin and cefotaxime. 1 2 This recommendation reflects the range of bacterial pathogens that cause these serious infections in the first 3 months of life. The inclusion of amoxicillin specifically acknowledges the importance of L. monocytogenes and highlights its non-susceptibility to thirdgeneration cephalosporins. CURRENT EPIDEMIOLOGYPopulation-based surveillance undertaken in England and Wales in the 1980s and 1990s showed that the aetiology and incidence of neonatal bacterial meningitis changed very little over this period with Group B streptococci and Escherichia coli being the leading causative organisms, followed by L. monocytogenes. 3 4 A more recent population-based surveillance study of bacterial meningitis in infants aged <90 days in the UK and Ireland undertaken between July 2010 and July 2011 showed that these three causative bacteria remained dominant, and that their frequency varied significantly by month of life. In the first 30 days of life, L. monocytogenes was the third most common bacteria, responsible for 6% of cases (compared with 7% and 5% (for the first 28 days) in the previous national studies). The median age of meningitis due to L. monocytogenes was 13 days (IQR 3-18 days) with the oldest infant being 29 days; Listeria meningitis was therefore not seen beyond the 1st month of life. 5 Of the 11 cases of Listeria meningitis, 7 (64%) were female, 2/9 (22%) were born preterm (<37 weeks gestation) and 6/9 (67%) first became unwell when at home. Outcome was known in nine cases and all survived although two cases (22%) had a serious complication at discharge (one baby had hydrocephalus while the second baby had focal neurological signs).A summary of all cases of L. monocytogenes infection (sepsis and meningitis inclusive) in infants <1 year of age reported to Public Health England over the 24 years period between 1990 and 2013 is shown in tables 1 and 2. This data expands on previously published surveillance. 6 Ninety-seven per cent of all cases (351/362), and 99% of all cases occurring in the first 90 days of life (351/356), presented in the first 30 days of life. Clinical presentation was kn...

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Section: Rational Antibiotic Prescribingmentioning

confidence: 99%

Empirical antibiotic cover for Listeria monocytogenes infection beyond the neonatal period: a time for change?

et al. 2015

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“…[19][20][21] It has been reported that the predominant bacteria causing pediatric PM are E. coli K1, S. agalactiae, and L. monocytogenes in neonatal patients and N. meningitidis, S. pneumoniae, and H. influenzae type b in patients beyond the neonatal period. 10,22 In our study, the etiology was identified in 42.5% of the patients upon combinatory tests by CSF culture and multiplex PCR assay. Therefore, a multiplex PCR assay is advised to perform with CSF culture in combination to improve the pathogenic diagnosis in patients with PM.…”

Section: Journal Of Pediatric Infectious Diseasesmentioning

confidence: 55%

Diagnostic Yield of Multiplex PCR Method in Cerebrospinal Fluid for the Diagnosis of Purulent Meningitis in Children

Zhao

Chen

Xie

et al. 2020

Journal of Pediatric Infectious Diseases

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Objective To evaluate the diagnostic yield of the multiplex polymerase chain reaction (PCR) method in cerebrospinal fluid (CSF) for the diagnosis of purulent meningitis (PM) in children. Methods PM was diagnosed according to the European Society for Clinical Microbiology and Infectious Diseases guideline (2016). Patients with PM between May 2015 and October 2018 were included. The multiplex PCR method was used to detect eight common identified bacteria in PM. Its sensitivity and specificity were compared with bacteria culture. Results A total of 106 cases were enrolled. Pathogenic bacteria were identified in 27 (25.5%) cases by culture and in 37 (34.9%) cases by multiplex PCR assay. The top three bacteria were Streptococcus pneumoniae, Escherichia coli K1, and Streptococcus agalactiae. When using culture as the gold standard, the multiplex PCR assay showed a sensitivity of 100, 88.9, and 75.0% for S. agalactiae, S. pneumoniae, and E. coli K1, respectively, and a specificity of more than 91.3% for all three bacteria. For detectable bacteria, the positive rate of the multiplex PCR assay (36.6%, 37/101) was significantly higher than that of the bacteria culture (21.8%, 22/101). When combining the two methods, etiology was identified in 42.5% (45/106) of the patients. Conclusion Streptococcus pneumoniae, E. coli K1, and S. agalactiae were the predominant pathogens causing pediatric PM. As a rapid method with high sensitivity and specificity, the multiplex PCR assay in CSF could be used as an adjunctive approach with bacteria culture for the pathogen identification of PM.

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“…У пацієнтів з імуносупресією з огляду на можливість лістеріозної інфекції до комбінованої терапії також додається ампіцилін. Меропенем рекомендується використовувати як препарат другого ряду [8,9]. У випадках госпітального інфікування серед можливих етіологічних чинників зростає роль резистентних грамнегативних бактерій і стафілококів.…”

Section: бактеріальний менінгітunclassified

Карбапенеми В Клінічній Практиці

Kramarov¹,

Yevtushenko²

2021

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Збільшення частоти інфекцій, викликаних мікроорганізмами з множинною лікарською стійкістю, спостерігається в даний час серед дорослого населення і дітей. Клініцист зобов’язаний використовувати антибіотики широкого спектра дії, коли це необхідно, коли потрібно таке потужне лікування. Карбапенеми є найбільш ефективними бета-лактамами, особливо щодо грамнегативних бактерій, і найбільш захищені від резистентності. У цьому огляді узагальнено мікробіологічні, фармакокінетичні й фармакодинамічні характеристики доступних на даний час кабапенемів. На основі опублікованих даних обговорюється клінічне використання кабапенемів у різних педіатричних умовах. Серед доступних карбапенемів меропенем має кращі фармакокінетичні й фармакодинамічні властивості, більш високу переносимість, його легше використовувати в педіатричній популяції.

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Guidelines for the management of suspected and confirmed bacterial meningitis in Canadian children older than one month of age

Cited by 29 publications

References 35 publications

Empirical antibiotic cover for Listeria monocytogenes infection beyond the neonatal period: a time for change?

Empirical antibiotic cover for Listeria monocytogenes infection beyond the neonatal period: a time for change?

Diagnostic Yield of Multiplex PCR Method in Cerebrospinal Fluid for the Diagnosis of Purulent Meningitis in Children

Карбапенеми В Клінічній Практиці

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