When to Perform Lumbar Puncture in Infants at Risk for Meningitis in the Neonatal Intensive Care Unit

Greenberg, Rachel G.; Herrera, Tamara

doi:10.1016/b978-0-323-54391-0.00008-4

Cited by 6 publications

(3 citation statements)

References 155 publications

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“…CSF culture is considered the gold-standard method for the diagnosis of meningitis. However, prior antibiotic therapy may reduce the sensitivity of CSF cultures, increasing the possibility of false-negatives ( Greenberg and Herrera, 2019 ). mNGS has potential to detect pathogens of unknown etiology as evidenced by clinical series demonstrating the success of mNGS in the detection of hard-to-diagnose CNS infection cases ( Miller et al, 2019 ; Wilson et al, 2019 ; Hasan et al, 2020 ; Haston et al, 2020 ; Chen et al, 2021b ; Morsli et al, 2022b ).…”

Section: Detection Of Pathogens Via Clinical Metagenomicsmentioning

confidence: 99%

Clinical metagenomics—challenges and future prospects

Batool

Galloway-Peña

2023

Front. Microbiol.

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Infections lacking precise diagnosis are often caused by a rare or uncharacterized pathogen, a combination of pathogens, or a known pathogen carrying undocumented or newly acquired genes. Despite medical advances in infectious disease diagnostics, many patients still experience mortality or long-term consequences due to undiagnosed or misdiagnosed infections. Thus, there is a need for an exhaustive and universal diagnostic strategy to reduce the fraction of undocumented infections. Compared to conventional diagnostics, metagenomic next-generation sequencing (mNGS) is a promising, culture-independent sequencing technology that is sensitive to detecting rare, novel, and unexpected pathogens with no preconception. Despite the fact that several studies and case reports have identified the effectiveness of mNGS in improving clinical diagnosis, there are obvious shortcomings in terms of sensitivity, specificity, costs, standardization of bioinformatic pipelines, and interpretation of findings that limit the integration of mNGS into clinical practice. Therefore, physicians must understand the potential benefits and drawbacks of mNGS when applying it to clinical practice. In this review, we will examine the current accomplishments, efficacy, and restrictions of mNGS in relation to conventional diagnostic methods. Furthermore, we will suggest potential approaches to enhance mNGS to its maximum capacity as a clinical diagnostic tool for identifying severe infections.

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Section: Detection Of Pathogens Via Clinical Metagenomicsmentioning

confidence: 99%

Clinical metagenomics—challenges and future prospects

Batool

Galloway-Peña

2023

Front. Microbiol.

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“…Complications of Lumber Puncture. Despite potential adverse effects, LP is not associated with increased mortality [177]. Traumatic or failed LP accounts for 30-50% of cases [178].…”

Section: Lumber Puncture (Lp)mentioning

confidence: 99%

Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

Zubi,

Abdullah,

Helmi

et al. 2023

International Journal of Pediatrics

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About 10% of newborns require some degree of assistance to begin their breathing, and 1% necessitates extensive resuscitation. Sick neonates are exposed to a number of invasive life-saving procedures as part of their management, either for investigation or for treatment. In order to support the neonates with the maximum possible benefits and reduce iatrogenic morbidity, health-care providers performing these procedures must be familiar with their indications, measurements, and potential complications. Hence, the aim of this review is to summarise ten of the main neonatal intensive care procedures with highlighting of their indications, measurements, and complications. They include the umbilical venous and arterial catheterizations and the intraosseous line which represent the principal postnatal emergency vascular accesses; the peripherally inserted central catheter for long-term venous access; the endotracheal tube and laryngeal mask airway for airway control and ventilation; chest tube for drainage of air and fluid from the thorax; and the nasogastric/orogastric tube for enteral feeding. Furthermore, lumber puncture and heel stick were included in this review as very important and frequently performed diagnostic procedures in the neonatal intensive care unit.

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“…Previously, acute phase C-reactive protein (CRP) and white blood cell counts were used to detect neonatal sepsis 7 . In the early neonatal sepsis stages; CRP is less sensitive but more specific [8][9] . The sepsis was confirmed by positive blood culture and a condition is considered clinical sepsis when the blood culture is negative.…”

Section: Introductionmentioning

confidence: 99%

Importance of Lumbar Puncture in Late Onset Sepsis

Muhammad¹,

Khan²,

Halim³

et al. 2022

PJMHS

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Neonatal sepsis is the significant reason of neonatal mortality and morbidity and mostly results in extended hospitalization of infants in the neonatal intensive care unit. The sepsis was confirmed by a positive blood culture and a condition is considered clinical sepsis when the blood culture is negative. It is practically not possible to clinically differentiate sepsis from neonatal meningitis. However, a positive CSF for pathogenic bacteria indicates meningitis. Aim: The purpose of this study was to evaluate the frequency of late-onset sepsis in neonates with meningitis and to determine whether CSF analysis and lumbar puncture is mandatory in all cases of late-onset sepsis. Methods: This study was conducted in the Paediatrics department of CMH Abbottabad, and Sharif Medical City Hospital Lahore, and Pathology department of Women Medical and Dental College, Abbottabad for the duration from January 2022 to June 2022 among neonates with late neonatal sepsis. All neonates underwent clinical examination, history, routine tests (blood culture, C-reactive protein, complete blood count) and analysis and culture of cerebrospinal fluid for clinical evaluation of sepsis. Results: All 80 neonates tested positive for clinical sepsis: hematological sepsis was seen in 59 patients and 21 were CSF culture positive for sepsis; 8 (38.9%) of the 21 have positive CSF culture and 13 cases have negative blood culture. The most common clinical symptom was poor suction 70(87.5%), followed by weak moor 61(76.3%), and lethargy 46(57.5%). The Klebsiella spp was common organism seen in 15 children in the blood culture and the most communal organism in the cerebrospinal fluid culture was Staphylococcus aureus in 6 cases. Conclusions: The incidence of neonatal meningitis is high in new-borns with late-onset sepsis. Meningitis in neonates often transpires in the absence of bacteraemia. Therefore, the CSF examination and lumbar puncture are compulsory in all children with late onset sepsis. Keywords: Lumbar puncture, Meningitis, Neonatal sepsis

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When to Perform Lumbar Puncture in Infants at Risk for Meningitis in the Neonatal Intensive Care Unit

Cited by 6 publications

References 155 publications

Clinical metagenomics—challenges and future prospects

Clinical metagenomics—challenges and future prospects

Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

Importance of Lumbar Puncture in Late Onset Sepsis

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