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Predictive value of repeated cerebrospinal fluid parameters in the outcomes of bacterial meningitis in infants <90 days of age.
Ting, Joseph Y; Roberts, Ashley; Khan, Sarah; Bitnun, Ari; Hawkes, Michael; Barton, Michelle; Bowes, Jennifer; Brophy, Jason; Ouchenir, Lynda; Renaud, Christian; Boisvert, Andrée-Anne; McDonald, Jane; Robinson, Joan L.
Afiliación
  • Ting JY; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
  • Roberts A; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
  • Khan S; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
  • Bitnun A; Hospital for Sick Children & University of Toronto, Toronto, Ontario, Canada.
  • Hawkes M; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
  • Barton M; Department of Pediatrics, Western University, London, Ontario, Canada.
  • Bowes J; Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
  • Brophy J; Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
  • Ouchenir L; Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.
  • Renaud C; Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.
  • Boisvert AA; Montréal Children's Hospital, McGill University, Montréal, Quebec, Canada.
  • McDonald J; Montréal Children's Hospital, McGill University, Montréal, Quebec, Canada.
  • Robinson JL; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
PLoS One ; 15(8): e0238056, 2020.
Article en En | MEDLINE | ID: mdl-32857801
BACKGROUND: There are variations in recommendations from different guidelines regarding the indications for repeat lumbar puncture (LP) in young infants with the diagnosis of bacterial meningitis. OBJECTIVE: To evaluate the frequency of repeat LPs and the characteristics of cerebrospinal fluid (CSF) parameters in repeated sampling and their predictive values for adverse outcomes in a national cohort. METHODS: This cohort study included infants born January 1, 2013 through December 31, 2014, who had proven or suspected bacterial meningitis within the first 90 days of life at seven paediatric tertiary care hospitals across Canada, and who underwent a repeat LP at the discretion of the treating physicians. RESULTS: Forty-nine of 111 infants (44%) underwent repeat LP at a median of 5 (IQR: 3, 13) days after the LP that led to the diagnosis of bacterial meningitis. Those who had meningitis caused by gram negative bacilli were more likely to have repeat LP than those with gram positive bacteria (77% versus 57%; p = 0.012). White blood cell (WBC) count on the second spinal tap yielded an area under the curve of 0.88 for predicting sequelae of meningitis at discharge from the hospital, with a cut-off value of 366 × 106/L, providing a sensitivity of 91% and specificity of 88%. CONCLUSION: In this multi-centre retrospective cohort study, infants with gram negative meningitis were more likely to have repeated LP. A high WBC on the second CSF sample was predictive of adverse outcome at the time of discharge from the hospital.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Líquido Cefalorraquídeo / Meningitis Bacterianas Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Líquido Cefalorraquídeo / Meningitis Bacterianas Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos