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The Epidemiology, Management, and Outcomes of Bacterial Meningitis in Infants.
Ouchenir, Lynda; Renaud, Christian; Khan, Sarah; Bitnun, Ari; Boisvert, Andree-Anne; McDonald, Jane; Bowes, Jennifer; Brophy, Jason; Barton, Michelle; Ting, Joseph; Roberts, Ashley; Hawkes, Michael; Robinson, Joan L.
Afiliación
  • Ouchenir L; Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada.
  • Renaud C; Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada.
  • Khan S; Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
  • Bitnun A; Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
  • Boisvert AA; Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
  • McDonald J; Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
  • Bowes J; Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
  • Brophy J; Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
  • Barton M; London Health Sciences Centre, Western University, London, Ontario, Canada.
  • Ting J; British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; and.
  • Roberts A; British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; and.
  • Hawkes M; Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
  • Robinson JL; Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada jr3@ualberta.ca.
Pediatrics ; 140(1)2017 Jul.
Article en En | MEDLINE | ID: mdl-28600447
OBJECTIVES: The pathogens that cause bacterial meningitis in infants and their antimicrobial susceptibilities may have changed in this era of increasing antimicrobial resistance, use of conjugated vaccines, and maternal antibiotic prophylaxis for group B Streptococcus (GBS). The objective was to determine the optimal empirical antibiotics for bacterial meningitis in early infancy. METHODS: This was a cohort study of infants <90 days of age with bacterial meningitis at 7 pediatric tertiary care hospitals across Canada in 2013 and 2014. RESULTS: There were 113 patients diagnosed with proven meningitis (n = 63) or suspected meningitis (n = 50) presented at median 19 days of age, with 63 patients (56%) presenting a diagnosis from home. Predominant pathogens were Escherichia coli (n = 37; 33%) and GBS (n = 35; 31%). Two of 15 patients presenting meningitis on day 0 to 6 had isolates resistant to both ampicillin and gentamicin (E coli and Haemophilus influenzae type B). Six of 60 infants presenting a diagnosis of meningitis from home from day 7 to 90 had isolates, for which cefotaxime would be a poor choice (Listeria monocytogenes [n = 3], Enterobacter cloacae, Cronobacter sakazakii, and Pseudomonas stutzeri). Sequelae were documented in 84 infants (74%), including 8 deaths (7%). CONCLUSIONS: E coli and GBS remain the most common causes of bacterial meningitis in the first 90 days of life. For empirical therapy of suspected bacterial meningitis, one should consider a third-generation cephalosporin (plus ampicillin for at least the first month), potentially substituting a carbapenem for the cephalosporin if there is evidence for Gram-negative meningitis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Meningitis Bacterianas / Antibacterianos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies / Screening_studies Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatrics Año: 2017 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Meningitis Bacterianas / Antibacterianos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies / Screening_studies Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatrics Año: 2017 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos