Predicting the Outcome of Neonatal Bacterial Meningitis

Klinger, G; Chin, Choy-Nyok; Beyene, Joseph; Perlman, Max

doi:10.1542/peds.106.3.477

Cited by 172 publications

(106 citation statements)

References 23 publications

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“…These data are consistent with data from developed countries [18][19][20]. A recent review on the incidence of neonatal meningitis infections reported 0.8 to 6.1 cases in every 1,000 live newborns [21].…”

Section: Introductionsupporting

confidence: 90%

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Neonatal bacterial meningitis in Turkey: epidemiology, risk factors, and prognosis

Kavuncuoğlu

Gürsoy

Türel

et al. 2013

J Infect Dev Ctries

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Introduction: We aimed to determine the incidence, etiology, risk factors and outcome of bacterial meningitis in neonates. Methodology: Neonates who developed bacterial meningitis between 2003 and 2010 in a tertiary hospital in Turkey were included in the study. Patients born in our hospital were defined as Group 1 and patients referred from other centres were defined as Group 2. Patients with evidence of congenital infections or central nervous system malformations were excluded. Demographic features, delivery type, time of onset of meningitis, co-morbidities, clinical features, blood and cerebrospinal fluid (CSF) analysis, cranial sonographic findings, and outcome of patients were recorded. Results: The study comprised 325 meningitis cases identified from 38,023 hospitalised patients in the neonatology unit among 11,8091 live births. Mean gestational age, birth weight, and hospital stay were 36.8±3.7 weeks, 2.480±924 g, and 26±12.4 days, respectively. Almost half (48%) of the patients were diagnosed in the first seven postnatal days and 52% at 8-30 days after birth. CSF culture findings were positive in 59 (18%) patients (28 in Group 1 and 31 in Group 2). Gram-positive bacteria were the responsible agents in 30 (51%) patients, whereas 26 (44%) patients had Gram-negative bacterial meningitis and 3 (5%) had Candida meningitis. Gram-negative bacteria were predominant in Group 1 whereas Gram positive bacteria were predominant in Group 2. Transfontanel ultrasonography revealed pathologic findings in 17.5% of patients. The total mortality rate was 2.5%. Conclusion: This large-scale study provides essential information about the etiology, characteristics, and outcome of neonatal bacterial meningitis in Turkey.

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Section: Introductionsupporting

confidence: 90%

“…In all decades, the incidence of meningitis was highest during the neonatal period [19]. The incidence of neonatal meningitis was reported as 0.72 per 1,000 live births in a previous study [9][10][11].…”

mentioning

confidence: 99%

Neonatal bacterial meningitis in Turkey: epidemiology, risk factors, and prognosis

Kavuncuoğlu

Gürsoy

Türel

et al. 2013

J Infect Dev Ctries

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“…ExPEC-related neonatal meningitis is associated with mortality rates approaching 40% and, in survivors, up to 50% develop significant neurological sequelae including seizures, hydrocephalus, encephalopathy and neurodevelopmental delay (44)(45)(46). The definitive mechanisms relating to blood brain barrier (BBB) invasion by ExPEC have yet to be completely elucidated, however the evidence base exploring these mechanisms comprising laboratory, animal and human studies continues to grow.…”

Section: Neonatal Meningitis-associated Vfsmentioning

confidence: 99%

Extra-intestinal pathogenic Escherichia coli (ExPEC): Disease, carriage and clones

Dale

Woodford

2015

Journal of Infection

165

132

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Extra-intestinal pathogenic E. coli (ExPEC) have a complex phylogeny, broad virulence factor (VF) armament and significant genomic plasticity, and are associated with a spectrum of host infective syndromes ranging from simple urinary tract infection to life-threatening bacteraemia. Their importance as pathogens has come to the fore in recent years, particularly in the context of the global emergence of hyper-virulent and antibiotic resistant strains.Despite this, the mechanisms underlying ExPEC transmission dynamics and clonal selection remain poorly understood. Large-scale epidemiological and clinical studies are urgently required to ascertain the mechanisms underlying these processes to enable the development of novel evidence-based preventative and therapeutic strategies. In the current review, we provide a concise summary of the methods utilised for ExPEC phylogenetic genetic delineation before exploring in detail the associations between ExPEC VFs and site-specific disease. We then consider the role of ExPEC as an intestinal colonist before outlining known associations between ExPEC clonal variation, specific disease syndromes and antibiotic resistance.

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“…27 According to previous studies, in meningitis by both group B streptococcus and gram-negative bacilli, 50% survivors had no sequelae, 40% had mild to moderate sequelae while only 10% had severe sequelae. [28][29][30] Present study was a prospective observational study with complete records of patients and following NICU protocols for seizure managements, still lack of continuous EEG monitoring, not a multicentric study and lack of advanced metabolic tests to confirm diagnosis of undiagnosed seizures are limitation of the present study. Hence there is a need of future studies to be done taking care of all limitations of the present study.…”

Section: Discussionmentioning

confidence: 94%

Clinico-etiological profile of seizures in term and near-term neonates: tertiary care hospital based observational study

Verma¹,

Shamsi²,

Pathak³

2017

Int J Contemp Pediatr

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Background: Neonatal period is very important for development of immature brain and it is also most vulnerable period for development of seizures. Seizures have varied etiology as well as presentation during neonatal period. Considering this we planned this study with objective of finding incidence, etiology, type and time of onset of seizures and their correlation along with short term outcome.Methods: It is a prospective observational study done in level 2 NICU set up of Government Medical College from November 2008 to September 2009. Total 115 term and near term neonates (≥35 weeks of gestation) presenting in NICU with seizures were enrolled in study. All relevant details were recorded on performa and investigations were sent. Data was described as mean±SD and %. SPSS 13 software was used as data analysis.Results: Incidence of seizures came out to be 6.1% of total NICU admission, which was more in male appropriate for gestational age (AGA) babies and those who were born vaginally, extramural and to primiparous mother. Birth asphyxia was most common etiology of seizures and majority presented within 24 hours of birth and meningitis was most important cause of seizure after 7 days of life. Subtle seizures were most common clinical type of seizure in the present study. Risk factor for poor neurological outcome came out to be Hypoxic Ischemic Encephalopathy (HIE). Conclusions: Hypoxic ischemic encephalopathy was most important etiology of neonatal seizures and most important risk factor for poor neurological outcome and subtle seizures being most common clinical type of seizure.

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Predicting the Outcome of Neonatal Bacterial Meningitis

Cited by 172 publications

References 23 publications

Neonatal bacterial meningitis in Turkey: epidemiology, risk factors, and prognosis

Neonatal bacterial meningitis in Turkey: epidemiology, risk factors, and prognosis

Extra-intestinal pathogenic Escherichia coli (ExPEC): Disease, carriage and clones

Clinico-etiological profile of seizures in term and near-term neonates: tertiary care hospital based observational study

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