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Epidemiology, microbiology and antibiotic treatment of bacterial and fungal meningitis among very preterm infants in China: a cross-sectional study.
Cheng, Ping; Qian, Aimin; Zhang, Hongbo; Wang, Yingying; Li, Shujuan; Sun, Mengya; Yang, Jie; Zhou, Jianguo; Hu, Liyuan; Lei, Xiaoping; Hu, Yu; Zhou, Ligang; Du, Lizhong; Cao, Yun; Lee, Shoo K; Zhou, Wenhao; Kang, Wenqing; Zhu, Changlian; Sun, Huiqing; Jiang, Siyuan.
Afiliación
  • Cheng P; Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.
  • Qian A; Department of Neonatology, Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, Henan, China.
  • Zhang H; Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
  • Wang Y; Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.
  • Li S; Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.
  • Sun M; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, Shanghai, China.
  • Yang J; The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
  • Zhou J; NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, Shanghai, China.
  • Hu L; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, Shanghai, China.
  • Lei X; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, Shanghai, China.
  • Hu Y; Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
  • Zhou L; Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
  • Du L; Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, Sichuan, China.
  • Cao Y; Zhejiang University School of Medicine Children's Hospital, Hangzhou, Zhejiang, China.
  • Lee SK; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, Shanghai, China.
  • Zhou W; Maternal-Infant Care Research Center and Department of Pediatrics, Mount Sinai Hospital Pediatrics, Toronto, Ontario, Canada.
  • Kang W; Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Zhu C; Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.
  • Sun H; Department of Neonatology, Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, Henan, China.
  • Jiang S; Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China jiangsiyuan@fudan.edu.cn s_huiqing@sina.com.
Arch Dis Child Fetal Neonatal Ed ; 2024 Sep 18.
Article en En | MEDLINE | ID: mdl-39299764
ABSTRACT

OBJECTIVE:

Neonatal meningitis significantly contributes to neonatal morbidity and mortality, yet large-scale epidemiological data in developing countries, particularly among very preterm infants (VPIs), remain sparse. This study aimed to describe the epidemiology of meningitis among VPIs in China.

DESIGN:

Cross-sectional study using the Chinese Neonatal Network database from 2019 to 2021.

SETTING:

79 tertiary neonatal intensive care units in China. PATIENTS Infants with gestational age <32 weeks or birth weight <1500 g. MAIN OUTCOME

MEASURES:

Incidence, pathogen distribution, antimicrobial use and outcomes of bacterial and fungal meningitis.

RESULTS:

Of 31 915 VPIs admitted, 122 (0.38%) infants were diagnosed with culture-confirmed meningitis, with 14 (11.5%) being early-onset (≤6 days of age) and 108 (88.5%) being late-onset (>6 days of age). The overall in-hospital mortality was 18.0% (22/122). A total of 127 pathogens were identified, among which 63.8% (81/127) were Gram-negative bacteria, 24.4% (31/127) were Gram-positive bacteria and 11.8% (15/127) were fungi. In terms of empirical therapy (on the day of the first lumbar puncture), the most commonly used antibiotic was meropenem (54.9%, 67/122). For definitive therapy (on the sixth day following the first lumbar puncture, 86 cases with available antibiotic data), meropenem (60.3%, 35/58) and vancomycin (57.1%, 16/28) were the most used antibiotics for Gram-negative and Gram-positive bacterial meningitis, respectively. 44% of infants with Gram-positive bacterial meningitis and 52% with Gram-negative bacterial meningitis received antibiotics for more than 3 weeks.

CONCLUSION:

0.38% of VPIs in Chinese neonatal intensive care units were diagnosed with meningitis, experiencing significant mortality and inappropriate antibiotic therapy. Gram-negative bacteria were the predominant pathogens, with fungi emerging as a significant cause.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arch Dis Child Fetal Neonatal Ed Asunto de la revista: PEDIATRIA / PERINATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arch Dis Child Fetal Neonatal Ed Asunto de la revista: PEDIATRIA / PERINATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido